1407295827 NPI number — HUDSON HOLDINGS INC

Table of content: (NPI 1407295827)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407295827 NPI number — HUDSON HOLDINGS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HUDSON HOLDINGS INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PRESTON PHARMACY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407295827
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/19/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2622 W CENTRAL AVE
Provider Second Line Business Mailing Address:
SUITE 302
Provider Business Mailing Address City Name:
WICHITA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67203-4969
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
316-265-3300
Provider Business Mailing Address Fax Number:
316-265-3304

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2900 SW WANAMAKER DR
Provider Second Line Business Practice Location Address:
SUITE 201 N
Provider Business Practice Location Address City Name:
TOPEKA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66614-4167
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
866-404-3300
Provider Business Practice Location Address Fax Number:
888-865-8108
Provider Enumeration Date:
06/19/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MCNAUGHT
Authorized Official First Name:
JERRI
Authorized Official Middle Name:
M
Authorized Official Title or Position:
DIRECTOR OF OPERATIONS
Authorized Official Telephone Number:
866-404-3300

Provider Taxonomy Codes

  • Taxonomy code: 3336L0003X , with the licence number:  2-10456 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)