=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043320310
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MEISTER, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/30/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19846 W KELLOGG DR
-----------------------------------------------------
City | GODDARD
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67052-9206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-794-2217
-----------------------------------------------------
Fax | 316-794-2899
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19846 W KELLOGG DR P.O. BOX 450
-----------------------------------------------------
City | GODDARD
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67052-9206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-794-2217
-----------------------------------------------------
Fax | 316-794-2899
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. RALPH EDWARD MEISTER
-----------------------------------------------------
Credential | R.PH.
-----------------------------------------------------
Telephone | 316-794-2217
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 2-07072
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------