Provider Demographics
NPI:1063868883
Name:TOURNESOL HEALTH LLC
Entity type:Organization
Organization Name:TOURNESOL HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOMBARDIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-614-3492
Mailing Address - Street 1:823 W 9TH ST
Mailing Address - Street 2:
Mailing Address - City:CONCORDIA
Mailing Address - State:KS
Mailing Address - Zip Code:66901-3325
Mailing Address - Country:US
Mailing Address - Phone:785-614-3492
Mailing Address - Fax:785-340-3277
Practice Address - Street 1:124 W 6TH ST
Practice Address - Street 2:
Practice Address - City:CONCORDIA
Practice Address - State:KS
Practice Address - Zip Code:66901-2820
Practice Address - Country:US
Practice Address - Phone:785-614-3492
Practice Address - Fax:785-340-3277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-11
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X, 3336L0003X
KS2-101620333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2166725OtherPK