Provider Demographics
NPI:1679939144
Name:MAY, ERIN COSTELLO (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:COSTELLO
Last Name:MAY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 N 47TH ST
Mailing Address - Street 2:ROOM 169
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66102-1705
Mailing Address - Country:US
Mailing Address - Phone:913-287-1600
Mailing Address - Fax:913-287-1607
Practice Address - Street 1:1301 N 47TH ST
Practice Address - Street 2:ROOM 169
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-1705
Practice Address - Country:US
Practice Address - Phone:913-287-1600
Practice Address - Fax:913-287-1607
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-13
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-15435183500000X
MO2011026593183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist