Provider Demographics
NPI:1619118502
Name:AISTROPE, DANIEL SCOTT (PHARMD, BCACP)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:SCOTT
Last Name:AISTROPE
Suffix:
Gender:M
Credentials:PHARMD, BCACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 PENNSYLVANIA AVE APT 2403
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64105-1468
Mailing Address - Country:US
Mailing Address - Phone:402-917-7305
Mailing Address - Fax:
Practice Address - Street 1:4435 MAIN ST STE 800
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-7723
Practice Address - Country:US
Practice Address - Phone:816-502-0445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-23
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN119357183500000X
DC61500071835P2201X
MO2010030706183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
6150007OtherBOARD OF PHARMACY SPECIALTIES
MN119357OtherBOARD OF PHARMACY LICENSE NUMBER
MO2010030706OtherBOARD OF PHARMACY LICENSE NUMBER