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General NPI Number Information
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NPI Number | 1649379538
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Entity Type | Organization
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Legal Business Name | RICKS PHARMACY AND WELLNESS INC
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 09/12/2008
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Provider Practice Location Address
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Address Line | 2315 W 21ST ST N SUITE 117
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City | WICHITA
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State | KS
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Zip | 67203-2150
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Country | US
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Telephone | 316-838-2100
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Fax | 316-838-7843
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Provider Business Mailing Address
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Address Line | 2315 W 21ST ST N SUITE 117
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City | WICHITA
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State | KS
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Zip | 67203-2150
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | FRANK TEJEDA
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Credential | RPH
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Telephone | 316-838-2100
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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 | 210043
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License Number State | KS
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