Healthcare Provider Details

I. General information

NPI: 1780744912
Provider Name (Legal Business Name): COSENTINO GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 E MAIN ST
GARDNER KS
66030-1252
US

IV. Provider business mailing address

13180 METCALF AVE
OVERLAND PARK KS
66213-2815
US

V. Phone/Fax

Practice location:
  • Phone: 913-856-2425
  • Fax: 913-856-2187
Mailing address:
  • Phone: 913-749-1511
  • Fax: 913-905-3027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2-09514
License Number StateKS

VIII. Authorized Official

Name: BRENTON FORESEE
Title or Position: DIRECTOR OF PHARMACY
Credential:
Phone: 913-749-1511