Provider Demographics
NPI:1609828722
Name:KOLLING PHARMACY INC
Entity type:Organization
Organization Name:KOLLING PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/RPH
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:R
Authorized Official - Last Name:KOLLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-762-5535
Mailing Address - Street 1:120 N EISENHOWER DR
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66441-3314
Mailing Address - Country:US
Mailing Address - Phone:785-762-5535
Mailing Address - Fax:785-762-4277
Practice Address - Street 1:120 N EISENHOWER DR
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:KS
Practice Address - Zip Code:66441-3314
Practice Address - Country:US
Practice Address - Phone:785-762-5535
Practice Address - Fax:785-762-4277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS7587OtherBC/BS OF KS
KS100436770AMedicaid
KA1895Medicare PIN
0212680001Medicare NSC