MEDICARE: DR. STEPHEN HAVENER 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	2004034221	MO
2	183500000X	Pharmacist	1-12912	KS

General Provider Information

NPI Number	:	1124550371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN HAVENER PHARMD

Provider Business Mailing Address
First Line	:	4001 MILL ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-3008
Country	:	US
Telephone Number	:	816-223-4538
Fax Number	:

Provider Business Practice Location Address
First Line	:	4001 MILL ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-3008
Country	:	US
Telephone Number	:	816-931-1505
Fax Number	:

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

Provider Enumeration Date	:	03/28/2017
Last Update Date	:	03/28/2017

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Directions to “ DR. STEPHEN HAVENER PHARMD” Practice Location

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