Healthcare Provider Details

I. General information

NPI: 1366371213
Provider Name (Legal Business Name): DARREN MICHAEL GENTRY PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 NW R D MIZE RD
BLUE SPRINGS MO
64014-2513
US

IV. Provider business mailing address

201 NW R D MIZE RD
BLUE SPRINGS MO
64014-2513
US

V. Phone/Fax

Practice location:
  • Phone: 816-655-5434
  • Fax: 816-655-5434
Mailing address:
  • Phone: 816-655-5434
  • Fax: 816-655-5438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number2008028411
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: