Healthcare Provider Details

I. General information

NPI: 1285238212
Provider Name (Legal Business Name): ONYINYE N OKONKWO PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2020
Last Update Date: 11/30/2020
Certification Date: 11/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 INDEPENDENCE AVE
KANSAS CITY MO
64125-1616
US

IV. Provider business mailing address

9714 WALNUT WOODS DR
KANSAS CITY MO
64139-1342
US

V. Phone/Fax

Practice location:
  • Phone: 816-231-2033
  • Fax: 816-231-2440
Mailing address:
  • Phone: 816-600-5390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number1710921184
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: