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General NPI Number Information
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NPI Number | 1477062891
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Entity Type | Organization
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Legal Business Name | HEALTHCORE CLINIC INC
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Dates
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Enumeration Date | 09/28/2017
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 2707 E 21ST ST N STE 201
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City | WICHITA
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State | KS
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Zip | 67214-2249
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Country | US
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Telephone | 316-768-5922
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Fax | 316-652-0331
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Provider Business Mailing Address
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Address Line | 2707 E 21ST ST N
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City | WICHITA
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State | KS
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Zip | 67214-2249
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Country | US
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Telephone | 316-691-0249
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Fax | 877-544-1063
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Authorized Official
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Title or Position | CEO
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Name | TERESA LOVELADY
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Credential |
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Telephone | 316-691-0249
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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 | 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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