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General NPI Number Information
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NPI Number | 1144247651
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Entity Type | Organization
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Legal Business Name | AD ASTRA PHARMACY LLC
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 1860 CLAFLIN RD
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City | MANHATTAN
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State | KS
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Zip | 66502-3413
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Country | US
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Telephone | 785-776-1200
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Fax | 785-776-1115
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Provider Business Mailing Address
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Address Line | 1860 CLAFLIN RD
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City | MANHATTAN
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State | KS
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Zip | 66502
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Country | US
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Telephone | 785-776-1200
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Fax | 785-776-1115
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Authorized Official
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Title or Position | MANAGER/OWNER
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Name | MILKA GOODLETT
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Credential | PHARM. D.
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Telephone | 785-776-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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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 | 1-11676
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License Number State | KS
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