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General NPI Number Information
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NPI Number | 1265511927
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Entity Type | Organization
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Legal Business Name | PROSCRIPT FAMILY PHARMACY
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 412 W MAIN ST
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City | INDEPENDENCE
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State | KS
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Zip | 67301-3517
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Country | US
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Telephone | 620-331-3292
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Fax | 620-331-1925
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Provider Business Mailing Address
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Address Line | 412 W MAIN ST
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City | INDEPENDENCE
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State | KS
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Zip | 67301-3517
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Country | US
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Telephone | 620-331-3292
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Fax | 620-331-1925
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Authorized Official
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Title or Position | PHARMACIST/MGR
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Name | MISS CATHY LYNN VINING SR.
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Credential | BS PHARMACY
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Telephone | 620-331-3292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | BP6807979
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License Number State | KS
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