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General NPI Number Information
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NPI Number | 1265293500
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Entity Type | Organization
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Legal Business Name | PHARMACY INNOVATIONS LLC
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Dates
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Enumeration Date | 01/23/2024
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 616 CEDAR ST
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City | CEDAR VALE
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State | KS
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Zip | 67024-9704
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Country | US
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Telephone | 620-758-2711
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Fax |
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Provider Business Mailing Address
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Address Line | 165 KAISER WAY
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City | DEWEY
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State | OK
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Zip | 74029-3029
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Country | US
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Telephone | 620-674-1596
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GAVIN DULEY
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Credential | PHARMD
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Telephone | 620-725-3262
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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 |
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License Number State |
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