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General NPI Number Information
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NPI Number | 1497376503
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Entity Type | Organization
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Legal Business Name | BALL BROTHERS RX, LLC
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Dates
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Enumeration Date | 04/29/2020
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Last Update Date | 05/13/2020
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Provider Practice Location Address
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Address Line | 1008 SE LOUIS DR
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City | MULVANE
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State | KS
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Zip | 67110-1109
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Country | US
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Telephone | 316-777-1601
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Fax | 316-777-1693
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Provider Business Mailing Address
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Address Line | 1008 SE LOUIS DR
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City | MULVANE
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State | KS
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Zip | 67110-1109
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Country | US
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Telephone | 316-777-1601
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Fax | 316-777-1693
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Authorized Official
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Title or Position | OWNER/PIC
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Name | CHADWICK L BALL
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Credential | PHARMD
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Telephone | 316-777-1601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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