MEDICARE: CENTER PHARMACY INC

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	3336C0003X	Community/Retail Pharmacy	03570	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2608036	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1083629612
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER PHARMACY INC

Provider Business Mailing Address
First Line	:	4357 N CHOUTEAU TRFY
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64117-1743
Country	:	US
Telephone Number	:	816-453-0200
Fax Number	:	816-452-6778

Provider Business Practice Location Address
First Line	:	4357 NE CHOUTEAU TFWY
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64117
Country	:	US
Telephone Number	:	816-453-0200
Fax Number	:	816-452-6778

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOHN PEER
Credential	:
Telephone Number	:	816-453-0200

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	07/01/2009

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Directions to “CENTER PHARMACY INC ” Practice Location

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