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NPI 1174891097 · on the registry since 2011 · sole proprietor
Practice
- Address
- 11021 Shawnee Mission Pkwy
Shawnee, KS 66203 - Phone
- (913) 268-4980
- Organisation at this address
- Walgreen Co
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 10
Registry record
- Primary taxonomy
- Pharmacist
183500000X
- Also registered as
- Pharmacist
Pharmacist - Licence states on file
- KS, MO, IA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2011-12-06
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Kansas