MEDICARE: SHARON LYNN CONKLIN PHARMACIST

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	1-10800	KS

General Provider Information

NPI Number	:	1497243562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON LYNN CONKLIN PHARMACIST

Provider Business Mailing Address
First Line	:	5714 ASH DR
Second Line	:
City	:	ROELAND PARK
State	:	KS
Zip	:	66205-2858
Country	:	US
Telephone Number	:	913-660-5093
Fax Number	:

Provider Business Practice Location Address
First Line	:	2803 S 47TH ST
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66106-3630
Country	:	US
Telephone Number	:	913-831-4140
Fax Number	:

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

Provider Enumeration Date	:	04/24/2018
Last Update Date	:	01/22/2021

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