Provider Demographics
NPI:1508811944
Name:SALEAUMUA INC
Entity Type:Organization
Organization Name:SALEAUMUA INC
Other - Org Name:THE MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:D
Authorized Official - Last Name:SALEAUMUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-599-1101
Mailing Address - Street 1:8345 LENEXA DR
Mailing Address - Street 2:SUITE 155
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66214-1654
Mailing Address - Country:US
Mailing Address - Phone:913-599-1101
Mailing Address - Fax:913-599-0017
Practice Address - Street 1:102 E MORGAN ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MO
Practice Address - Zip Code:65340-2113
Practice Address - Country:US
Practice Address - Phone:660-886-6590
Practice Address - Fax:660-886-6090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0064513336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0838720006Medicare ID - Type Unspecified