Provider Demographics
NPI:1659654606
Name:EPPLER, BRENT ERIC (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:BRENT
Middle Name:ERIC
Last Name:EPPLER
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11104 W 327TH ST
Mailing Address - Street 2:
Mailing Address - City:PAOLA
Mailing Address - State:KS
Mailing Address - Zip Code:66071-7213
Mailing Address - Country:US
Mailing Address - Phone:913-594-2880
Mailing Address - Fax:
Practice Address - Street 1:8450 W 151ST ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-2108
Practice Address - Country:US
Practice Address - Phone:913-814-7977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11659183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist