Healthcare Provider Details

I. General information

NPI: 1780774927
Provider Name (Legal Business Name): HOFFMAN PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 04/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 MAIN ST
WESTMORELAND KS
66549-9836
US

IV. Provider business mailing address

PO BOX 130
WESTMORELAND KS
66549-0130
US

V. Phone/Fax

Practice location:
  • Phone: 785-457-3611
  • Fax: 785-457-3611
Mailing address:
  • Phone: 785-457-3611
  • Fax:

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 Number2-04219
License Number StateKS

VIII. Authorized Official

Name: WILLIAM HOFFMAN
Title or Position: OWNER
Credential: RPH
Phone: 785-457-3611