Provider Demographics
NPI:1992450878
Name:STORMONT VAIL PHARMACY, LLC
Entity type:Organization
Organization Name:STORMONT VAIL PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR AMBULATORY PHARMACY SERVIC
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:WINSTON
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-270-8690
Mailing Address - Street 1:830 SW LANE ST STE B
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-2488
Mailing Address - Country:US
Mailing Address - Phone:785-235-8796
Mailing Address - Fax:785-235-1939
Practice Address - Street 1:830 SW LANE ST STE B
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-2488
Practice Address - Country:US
Practice Address - Phone:785-235-8796
Practice Address - Fax:785-235-1939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-18
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy