Healthcare Provider Details

I. General information

NPI: 1316438658
Provider Name (Legal Business Name): BRINK HEALTHMEDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2018
Last Update Date: 05/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 EAST 63RD STREET
KANSAS CITY MO
64110
US

IV. Provider business mailing address

1620 EAST 63RD STREET
KANSAS CITY MO
64110
US

V. Phone/Fax

Practice location:
  • Phone: 816-929-8902
  • Fax: 816-929-8945
Mailing address:
  • Phone: 816-929-8902
  • Fax: 816-929-8945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. FELICIA UDOJI
Title or Position: CLINICAL MANAGER
Credential: PHARM.D.
Phone: 816-929-8902