Provider Demographics
NPI:1336419761
Name:GUPTA, HARSH (PHARMD)
Entity Type:Individual
Prefix:
First Name:HARSH
Middle Name:
Last Name:GUPTA
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 1:7500 WORNALL RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-1816
Mailing Address - Country:US
Mailing Address - Phone:816-444-4179
Mailing Address - Fax:816-444-7159
Practice Address - Street 1:7500 WORNALL RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-1816
Practice Address - Country:US
Practice Address - Phone:816-444-4179
Practice Address - Fax:816-444-7159
Is Sole Proprietor?:No
Enumeration Date:2012-01-02
Last Update Date:2012-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011023417183500000X
KS1-15273183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist