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General NPI Number Information
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NPI Number | 1891708509
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Entity Type | Individual
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Provider Name | JAN R GRANADOS PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 01/29/2021
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Provider Practice Location Address
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Address Line | 131 S. MAIN ST
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City | MINNEOLA
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State | KS
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Zip | 67865
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Country | US
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Telephone | 620-855-2242
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 460
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City | MINNEOLA
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State | KS
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Zip | 67865-0460
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Country | US
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Telephone | 620-885-4544
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Fax | 620-885-4723
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1-13847
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License Number State | KS
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