Healthcare Provider Details

I. General information

NPI: 1114921798
Provider Name (Legal Business Name): WINFIELD PHARMACY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2005
Last Update Date: 10/18/2024
Certification Date: 10/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1708 E 9TH AVE
WINFIELD KS
67156-3220
US

IV. Provider business mailing address

PO BOX 756
WINFIELD KS
67156-0756
US

V. Phone/Fax

Practice location:
  • Phone: 620-221-0450
  • Fax: 620-221-7681
Mailing address:
  • Phone: 620-221-0450
  • Fax: 620-221-7681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2-09980
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number2-10380
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number2-10380
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number2-10380
License Number StateKS
# 5
Primary TaxonomyN
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number2-10380
License Number StateKS
# 6
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number2-10380
License Number StateKS
# 7
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. KENT E VRATIL
Title or Position: OWNER
Credential:
Phone: 620-221-0450