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NPI Code Detail

MEDICARE: YATES CENTER DRUG INC

MEDICARE: YATES CENTER DRUG INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy
33336L0003XLong Term Care Pharmacy

General Provider Information

NPI Number : 1104682095
Entity Type Code : Organization
Provider Name (Legal Business Name) : YATES CENTER DRUG INC
Provider Business Mailing Address
First Line : 122 W RUTLEDGE ST
Second Line :
City : YATES CENTER
State : KS
Zip : 66783-1238
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 122 W RUTLEDGE ST
Second Line :
City : YATES CENTER
State : KS
Zip : 66783-1238
Country : US
Telephone Number : 620-625-2221
Fax Number : 620-625-2453
Authorized Official
Title or Position : PRESIDENT
Name : LANCE MICHAEL FREEMAN
Credential :
Telephone Number : 620-842-5119
Provider Enumeration Date : 02/27/2024
Last Update Date : 02/27/2024

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Directions to “YATES CENTER DRUG INC ” Practice Location

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