Provider Demographics
NPI:1922194877
Name:MISSOURI KANSAS REGIONAL ASSN. OF MEDICINE SHOPPES INC
Entity Type:Organization
Organization Name:MISSOURI KANSAS REGIONAL ASSN. OF MEDICINE SHOPPES INC
Other - Org Name:MKRAMS OR MO KS ASSOC. OF MED SHOPPES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:DOWNING
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:913-492-4998
Mailing Address - Street 1:539 EAST SANTA FE
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-3458
Mailing Address - Country:US
Mailing Address - Phone:913-764-1800
Mailing Address - Fax:913-764-9127
Practice Address - Street 1:539 E SANTA FE ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-3419
Practice Address - Country:US
Practice Address - Phone:913-764-1800
Practice Address - Fax:913-764-9127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2-08444333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
9004292Medicare PIN
KS9003917Medicare ID - Type UnspecifiedPHARMACY