Provider Demographics
NPI:1578130050
Name:BOSWELL, ERIN O'GRADY (PHARMD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:O'GRADY
Last Name:BOSWELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:O'GRADY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6435 OUTLOOK DR
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-4217
Mailing Address - Country:US
Mailing Address - Phone:913-638-1442
Mailing Address - Fax:
Practice Address - Street 1:2301 HOLMES ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-2677
Practice Address - Country:US
Practice Address - Phone:816-404-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019024405183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist