Healthcare Provider Details

I. General information

NPI: 1710428362
Provider Name (Legal Business Name): DEBRA EDLER RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2017
Last Update Date: 03/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10600 QUIVIRA RD SUITE 100
OVERLAND PARK KS
66215-2309
US

IV. Provider business mailing address

10600 QUIVIRA RD SUITE 100
OVERLAND PARK KS
66215-2309
US

V. Phone/Fax

Practice location:
  • Phone: 913-541-5050
  • Fax: 913-541-6021
Mailing address:
  • Phone: 913-541-5050
  • Fax: 913-541-6021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11286
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number042448
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: