Healthcare Provider Details

I. General information

NPI: 1619118502
Provider Name (Legal Business Name): DANIEL SCOTT AISTROPE PHARM.D., BCACP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2009
Last Update Date: 01/07/2021
Certification Date: 01/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4435 MAIN ST STE 800
KANSAS CITY MO
64111-7723
US

IV. Provider business mailing address

1221 PENNSYLVANIA AVE APT 2403
KANSAS CITY MO
64105-1468
US

V. Phone/Fax

Practice location:
  • Phone: 816-502-0445
  • Fax:
Mailing address:
  • Phone: 402-917-7305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number119357
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number6150007
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2010030706
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: