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General NPI Number Information
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NPI Number | 1851390405
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Entity Type | Organization
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Legal Business Name | YATES CENTER PHARMACY, INC
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Dates
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Enumeration Date | 07/16/2005
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Last Update Date | 04/28/2011
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Provider Practice Location Address
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Address Line | 122 W RUTLEDGE ST
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City | YATES CENTER
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State | KS
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Zip | 66783-1238
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Country | US
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Telephone | 620-625-2221
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Fax | 620-625-2453
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Provider Business Mailing Address
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Address Line | 122 W RUTLEDGE ST
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City | YATES CENTER
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State | KS
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Zip | 66783-1238
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Country | US
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Telephone | 620-625-2221
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Fax | 620-625-2453
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Authorized Official
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Title or Position | PHARMACIST/PRESIDENT
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Name | GERALD J SEDLACEK
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Credential | RPH
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Telephone | 620-625-2221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 208078
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0193610001
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 208078
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License Number State | KS
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