Provider Demographics
NPI:1215087507
Name:LANSING PHARMACY LC
Entity type:Organization
Organization Name:LANSING PHARMACY LC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:WINTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-777-0609
Mailing Address - Street 1:PO BOX 6680
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-6680
Mailing Address - Country:US
Mailing Address - Phone:816-777-0609
Mailing Address - Fax:
Practice Address - Street 1:121 EXPRESS LN
Practice Address - Street 2:SUITE A
Practice Address - City:LANSING
Practice Address - State:KS
Practice Address - Zip Code:66043-1383
Practice Address - Country:US
Practice Address - Phone:913-250-0400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2-101273336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200568850AMedicaid
KS200568850BMedicaid
KS5429660002Medicare NSC