Provider Demographics
NPI:1982220372
Name:WARNER, JACKSON (PHARMD)
Entity Type:Individual
Prefix:
First Name:JACKSON
Middle Name:
Last Name:WARNER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8919 PARALLEL PKWY STE 250
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66112-1655
Mailing Address - Country:US
Mailing Address - Phone:913-335-6000
Mailing Address - Fax:833-209-6071
Practice Address - Street 1:8919 PARALLEL PKWY STE 250
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-1655
Practice Address - Country:US
Practice Address - Phone:913-335-6000
Practice Address - Fax:833-209-6071
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-106906183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist