Provider Information for 1407221773
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COSENTINO GROUP INC
Other Names:Doing Business As:PRICE CHOPPER PHARMACY #415Organization Subpart: NO
NPI: 1407221773
Last Updated: 2015-12-11
Certification Date:
Certification Date:
Details
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NPI | 1407221773 | ||||||||
Enumeration Date | 2015-12-11 | ||||||||
NPI Type | NPI-2 Organization | ||||||||
Status | Active | ||||||||
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 | ||||||||
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