Healthcare Provider Details

I. General information

NPI: 1093818056
Provider Name (Legal Business Name): SENIOR CARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 07/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1402 S RIDGE RD
WICHITA KS
67209-2908
US

IV. Provider business mailing address

1402 S RIDGE RD
WICHITA KS
67209-2908
US

V. Phone/Fax

Practice location:
  • Phone: 316-945-7455
  • Fax: 316-945-7457
Mailing address:
  • Phone: 316-945-7455
  • Fax: 316-945-7457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number2-10315
License Number StateKS

VIII. Authorized Official

Name: MARY MEEKER
Title or Position: PRESIDENT
Credential: APRN
Phone: 316-945-7455