=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750370318
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HUNTER DRUG
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/17/2005
-----------------------------------------------------
Last Update Date | 03/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 121 S MAIN ST
-----------------------------------------------------
City | GREENSBURG
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67054-1725
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 620-723-2331
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 121 S MAIN ST
-----------------------------------------------------
City | GREENSBURG
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67054-1725
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 620-723-2331
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PHARMACIST
-----------------------------------------------------
Name | MRS. JAMIE MCELWAIN
-----------------------------------------------------
Credential | R.PH.
-----------------------------------------------------
Telephone | 620-723-2331
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 206327
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------