NPI 1003206442

Kent Waldron, RPH

Practitioner Pharmacist Johnson, KS

Practice location

Address: 111 S. Main, Johnson, KS 67855-0579
Phone: (620) 492-3263
Fax: (620) 492-3318
Mailing address: PO Box 579 305 N Park, Johnson, KS 67855-0579

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 1-12675 (KS)

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Registry record

NPI: 1003206442
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Jan 2015
Record last updated: 23 Jan 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.