Healthcare Provider Details

I. General information

NPI: 1952408791
Provider Name (Legal Business Name): HESSTON PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S MAIN ST
HESSTON KS
67062-8940
US

IV. Provider business mailing address

PO BOX 636
HESSTON KS
67062-0636
US

V. Phone/Fax

Practice location:
  • Phone: 620-327-2211
  • Fax: 620-327-2500
Mailing address:
  • Phone: 620-327-2211
  • Fax: 620-327-2500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2-07799
License Number StateKS

VIII. Authorized Official

Name: THOMAS HOSKINS
Title or Position: PHMCST IN CHRG/OWNER
Credential: RPH
Phone: 620-327-2211