Provider Demographics
NPI:1255626149
Name:SALAS, AMY S (PHARMD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:S
Last Name:SALAS
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 1:10900 STADIUM PKWY
Mailing Address - Street 2:T2222
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66111-8100
Mailing Address - Country:US
Mailing Address - Phone:913-905-0317
Mailing Address - Fax:
Practice Address - Street 1:10900 STADIUM PKWY
Practice Address - Street 2:T2222
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66111-8100
Practice Address - Country:US
Practice Address - Phone:913-905-0317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-18
Last Update Date:2011-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-15189183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist