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Provider Information for 1407221773


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COSENTINO GROUP INC

Other Names:  
Doing Business As: 
PRICE CHOPPER PHARMACY #415

Organization Subpart: NO

NPI: 1407221773
Last Updated: 2015-12-11
Certification Date:

Details

NameValue
NPI1407221773
Enumeration Date2015-12-11
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: FRANK WOLFF
Title: Director of Pharmacy
Phone: 9137491511
Mailing Address 3901 W 83RD ST
PRAIRIE VILLAGE, KS 66208-5308
United States

Phone: 913-749-1511 | Fax:913-905-3027
 
Primary Practice Address 2600 ENSIGN HILL DR
PLATTE CITY, MO 64079-7836
United States

Phone: 816-431-2751 | Fax:816-431-2306
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 3336C0003X - Pharmacy - Community/Retail PharmacyMO2015043216