Healthcare Provider Details

I. General information

NPI: 1689587206
Provider Name (Legal Business Name): KENNETH MCNAMAR PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 COMMODORE ST
PRATT KS
67124-2903
US

IV. Provider business mailing address

200 COMMODORE ST
PRATT KS
67124-2903
US

V. Phone/Fax

Practice location:
  • Phone: 620-405-1246
  • Fax:
Mailing address:
  • Phone: 620-405-1246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1-109472
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: