MEDICARE: DR. KAMILE JOHNSON PHARMD

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	2007013058	MO

General Provider Information

NPI Number	:	1093096851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAMILE JOHNSON PHARMD

Provider Business Mailing Address
First Line	:	3545 BROADWAY ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-2501
Country	:	US
Telephone Number	:	816-756-1924
Fax Number	:	816-756-5302

Provider Business Practice Location Address
First Line	:	3545 BROADWAY ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-2501
Country	:	US
Telephone Number	:	816-756-1924
Fax Number	:	816-756-5302

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

Provider Enumeration Date	:	09/06/2011
Last Update Date	:	09/06/2011

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