Healthcare Provider Details

I. General information

NPI: 1508919515
Provider Name (Legal Business Name): KEVIN L KRILEY RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/21/2007
Last Update Date: 07/29/2020
Certification Date: 07/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 S MAIN ST
SMITH CENTER KS
66967-2605
US

IV. Provider business mailing address

125 S MAIN ST
SMITH CENTER KS
66967-2605
US

V. Phone/Fax

Practice location:
  • Phone: 785-282-6843
  • Fax: 785-282-6844
Mailing address:
  • Phone: 785-282-6843
  • Fax: 785-282-6844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11052
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number29239
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number208877
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: