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NPI Code Detail

MEDICARE: JACKSON RUSH PHARMD

MEDICARE: JACKSON RUSH 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
1183500000XPharmacist1-115405KS

General Provider Information

NPI Number : 1407712615
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACKSON RUSH PHARMD
Provider Business Mailing Address
First Line : 14955 W 151ST ST
Second Line :
City : OLATHE
State : KS
Zip : 66062-3110
Country : US
Telephone Number : 913-780-9449
Fax Number :
Provider Business Practice Location Address
First Line : 14955 W 151ST ST
Second Line :
City : OLATHE
State : KS
Zip : 66062-3110
Country : US
Telephone Number : 913-780-9449
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/31/2025
Last Update Date : 12/31/2025

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Directions to “ JACKSON RUSH PHARMD” Practice Location

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