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General NPI Number Information
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NPI Number | 1083016679
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Entity Type | Organization
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Legal Business Name | WEIMER DRUG STORE, INC
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Dates
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Enumeration Date | 09/25/2014
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Last Update Date | 11/12/2014
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Provider Practice Location Address
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Address Line | 685 LEWIS AVE
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City | SALINA
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State | KS
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Zip | 67401
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Country | US
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Telephone | 785-825-0778
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Fax | 785-827-7415
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Provider Business Mailing Address
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Address Line | 685 LEWIS AVE
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City | SALINA
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State | KS
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Zip | 67401
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Country | US
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Telephone | 785-825-0778
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Fax | 785-827-7415
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Authorized Official
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Title or Position | PIC AND MANAGER
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Name | TIMOTHY L GRUEN
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Credential | RPH
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Telephone | 785-825-0778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 2-13047
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 2-13047
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License Number State | KS
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