Provider Demographics
NPI:1164709473
Name:POKORNEY, JAMES A (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:POKORNEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6450 SPRINT PKWY
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66251-6105
Mailing Address - Country:US
Mailing Address - Phone:913-315-6432
Mailing Address - Fax:913-439-5990
Practice Address - Street 1:6450 SPRINT PKWY
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66251-6105
Practice Address - Country:US
Practice Address - Phone:913-315-6432
Practice Address - Fax:913-439-5990
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-12604183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100432210CMedicaid