Healthcare Provider Details

I. General information

NPI: 1326461278
Provider Name (Legal Business Name): DANDURAND COMPOUNDING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2014
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2233 N RIDGE RD
WICHITA KS
67205-1099
US

IV. Provider business mailing address

2233 N RIDGE ROAD
WICHITA KS
67212
US

V. Phone/Fax

Practice location:
  • Phone: 316-685-2353
  • Fax: 316-685-5331
Mailing address:
  • Phone: 316-685-2353
  • Fax: 316-685-5331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number2-13023
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JASON C. SCHMITZ
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 316-250-8609