Provider Demographics
NPI:1760781975
Name:OVERCAST, MONTE DEAN (PHARMD, BCPS)
Entity Type:Individual
Prefix:
First Name:MONTE
Middle Name:DEAN
Last Name:OVERCAST
Suffix:
Gender:M
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8505 N EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64157-9577
Mailing Address - Country:US
Mailing Address - Phone:816-415-4866
Mailing Address - Fax:
Practice Address - Street 1:197 N MCCLEARY RD
Practice Address - Street 2:
Practice Address - City:EXCELSIOR SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64024-8490
Practice Address - Country:US
Practice Address - Phone:816-922-2972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20030158461835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy