MEDICARE: MARIA MCCOY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	1999138372	MO

General Provider Information

NPI Number	:	1023612256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA MCCOY

Provider Business Mailing Address
First Line	:	5011 MAIN ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64112-2756
Country	:	US
Telephone Number	:	816-531-4966
Fax Number	:

Provider Business Practice Location Address
First Line	:	5011 MAIN ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64112-2756
Country	:	US
Telephone Number	:	816-531-4699
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2020
Last Update Date	:	01/02/2021

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Directions to “ MARIA MCCOY ” Practice Location

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