Healthcare Provider Details

I. General information

NPI: 1326423807
Provider Name (Legal Business Name): STEVEN PHIPPS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2015
Last Update Date: 07/09/2022
Certification Date: 07/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6860 W 115TH ST STE 150
OVERLAND PARK KS
66211-2454
US

IV. Provider business mailing address

1920 HIGHWAY 73
ATCHISON KS
66002-5102
US

V. Phone/Fax

Practice location:
  • Phone: 855-427-4682
  • Fax:
Mailing address:
  • Phone: 913-367-6142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1-16937
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: