Provider Demographics
NPI:1780800557
Name:BUMPUS, CHARLES PHILIP (RPH)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:PHILIP
Last Name:BUMPUS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8315 N MARSTON AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64151-3715
Mailing Address - Country:US
Mailing Address - Phone:816-436-6430
Mailing Address - Fax:
Practice Address - Street 1:6437 N COSBY AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64151-2378
Practice Address - Country:US
Practice Address - Phone:816-505-4410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005036831183500000X
VA0202004177183500000X
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist