Healthcare Provider Details

I. General information

NPI: 1902610363
Provider Name (Legal Business Name): SELECTRX KS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2025
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 W. FRONTIER LANE
OLATHE KS
66061-7221
US

IV. Provider business mailing address

418 W. FRONTIER LANE
OLATHE KS
66061-7221
US

V. Phone/Fax

Practice location:
  • Phone: 888-705-6810
  • Fax: 317-913-0930
Mailing address:
  • Phone: 888-705-6810
  • Fax: 317-913-0930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: WHITTNEY D. STEELE
Title or Position: PHARMACIST IN CHARGE
Credential:
Phone: 888-705-6810