Provider Demographics
NPI:1699846980
Name:MCCORMICKS PHARMACY
Entity Type:Organization
Organization Name:MCCORMICKS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-756-1733
Mailing Address - Street 1:6301 ROCKHILL RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-1117
Mailing Address - Country:US
Mailing Address - Phone:816-756-1733
Mailing Address - Fax:816-931-1540
Practice Address - Street 1:6301 ROCKHILL RD
Practice Address - Street 2:SUITE 104
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-1117
Practice Address - Country:US
Practice Address - Phone:816-756-1733
Practice Address - Fax:816-931-1540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-10
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO54253336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0540760001Medicare NSC