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General NPI Number Information
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NPI Number | 1255765152
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Entity Type | Organization
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Legal Business Name | FREEMAN PHARMACY LLC
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Dates
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Enumeration Date | 08/27/2013
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 530 MAIN ST
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City | KIOWA
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State | KS
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Zip | 67070-1406
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Country | US
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Telephone | 620-825-4782
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Fax | 620-825-4562
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Provider Business Mailing Address
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Address Line | 530 MAIN ST
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City | KIOWA
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State | KS
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Zip | 67070-1406
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Country | US
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Telephone | 620-825-4782
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | LANCE FREEMAN
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Credential |
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Telephone | 620-886-5161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 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 #3
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 2-12997
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License Number State | KS
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