Healthcare Provider Details

I. General information

NPI: 1437072717
Provider Name (Legal Business Name): CHRISTOPHER TODD INGRAM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 W 8TH ST APT 318
KANSAS CITY MO
64105-1520
US

IV. Provider business mailing address

308 W 8TH ST APT 318
KANSAS CITY MO
64105-1520
US

V. Phone/Fax

Practice location:
  • Phone: 319-899-9003
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2026036372
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: