Healthcare Provider Details

I. General information

NPI: 1124102900
Provider Name (Legal Business Name): DENALI CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 MARKET ST
LA CYGNE KS
66040-4100
US

IV. Provider business mailing address

945 MARKET ST
LA CYGNE KS
66040-4100
US

V. Phone/Fax

Practice location:
  • Phone: 913-757-4744
  • Fax: 913-398-7757
Mailing address:
  • Phone: 913-757-4744
  • Fax: 913-398-7757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2-10389
License Number StateKS

VIII. Authorized Official

Name: DENISE BURNS
Title or Position: OWNER
Credential: RPH
Phone: 913-757-4744