Healthcare Provider Details

I. General information

NPI: 1407925423
Provider Name (Legal Business Name): PHILIP JOHN SPITZNAGLE RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

937 NE WOODS CHAPEL RD PRICE CHOPPER PHARMACY
LEE'S SUMMIT MO
64064
US

IV. Provider business mailing address

315 SE CRESCENT ST
LEES SUMMIT MO
64063-3411
US

V. Phone/Fax

Practice location:
  • Phone: 816-246-7300
  • Fax: 816-875-1015
Mailing address:
  • Phone: 816-246-7300
  • Fax: 816-875-1015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number042838
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: