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Provider Information for 1669432456


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PHARMACEUTICAL ASSOCIATES II

Other Names:  
Doing Business As: 
SABETHA HEALTHMART

Organization Subpart: NO

NPI: 1669432456
Last Updated: 2024-05-31
Certification Date: 2024-05-26

Details

NameValue
NPI1669432456
Enumeration Date2006-03-24
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: JULIE K HAMMES
Title: Partner/Controller
Phone: 7855485616
Mailing Address 302 EDWARD ST
ATTN: JULIE HAMMES
SENECA, KS 66538-1829
United States

Phone: 785-548-5616 | Fax:785-284-3040
 
Primary Practice Address 934 MAIN ST
SABETHA, KS 66534-1829
United States

Phone: 785-284-3414 | Fax:785-284-3040
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDKS30003922500001
MEDICAIDKS30003922500002
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 332B00000X - Durable Medical Equipment & Medical Supplies
Yes 333600000X - Pharmacy KS2-06723
No 333600000X - Pharmacy
No 3336C0004X - Pharmacy - Compounding Pharmacy
No 3336L0003X - Pharmacy - Long Term Care Pharmacy