Healthcare Provider Details

I. General information

NPI: 1932017324
Provider Name (Legal Business Name): TEVIN GRANT TAYLOR PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 W 136TH ST
KANSAS CITY MO
64145-1647
US

IV. Provider business mailing address

1301 E 24TH ST
KANSAS CITY MO
64108-2964
US

V. Phone/Fax

Practice location:
  • Phone: 816-412-0109
  • Fax:
Mailing address:
  • Phone: 660-227-0418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2026041670
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: