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General NPI Number Information
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NPI Number | 1629193701
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Entity Type | Organization
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Legal Business Name | LEEKERS HAYSVILLE, LLC
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 08/20/2024
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Provider Practice Location Address
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Address Line | 201 N MAIN ST
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City | HAYSVILLE
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State | KS
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Zip | 67060-1813
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Country | US
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Telephone | 316-522-5583
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Fax | 316-524-4197
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Provider Business Mailing Address
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Address Line | PO BOX 25008
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City | OKLAHOMA CITY
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State | OK
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Zip | 73125
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Country | US
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Telephone | 405-290-3423
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Fax | 405-290-3523
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Authorized Official
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Title or Position | DIRECTOR
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Name | KENT BRAND
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Credential |
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Telephone | 316-744-3948
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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 | 209968
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License Number State | KS
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