Healthcare Provider Details

I. General information

NPI: 1407238009
Provider Name (Legal Business Name): CK PHARMACIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2015
Last Update Date: 01/17/2021
Certification Date: 01/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 N WALNUT ST
PEABODY KS
66866-1060
US

IV. Provider business mailing address

PO BOX 112
MCPHERSON KS
67460-0112
US

V. Phone/Fax

Practice location:
  • Phone: 620-983-2162
  • Fax: 620-983-2313
Mailing address:
  • Phone: 620-983-2162
  • Fax: 620-983-2313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2-13184
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. STEVE RAY KUDER
Title or Position: MANAGING-MEMBER OF CK PHARMACIES, L
Credential: PHARMD
Phone: 620-983-2162