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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
1332B00000XDurable Medical Equipment & Medical Supplies
23336L0003XLong Term Care Pharmacy
33336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31851390405OTHERKSNPI DME DEPARTMENT

General Provider Information

NPI Number : 1962506162
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 : 620-625-2221
Fax Number : 620-625-2453
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 : OWNER
Name : DR. LANCE FREEMAN
Credential : PHARMD
Telephone Number : 620-625-2221
Provider Enumeration Date : 09/11/2006
Last Update Date : 02/17/2021

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Practice Fax: 620-625-2453

Directions to “YATES CENTER DRUG INC ” Practice Location

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