Healthcare Provider Details

I. General information

NPI: 1740229541
Provider Name (Legal Business Name): SALEAUMUA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1822 N MAIN ST
HIGGINSVILLE MO
64037-1525
US

IV. Provider business mailing address

8345 LENEXA DR SUITE 155
LENEXA KS
66214-1654
US

V. Phone/Fax

Practice location:
  • Phone: 660-584-2700
  • Fax: 660-584-3073
Mailing address:
  • Phone: 913-599-1101
  • Fax: 913-599-0017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number006447
License Number StateMO

VIII. Authorized Official

Name: RAYMOND D SALEAUMUA
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 913-599-1101