Healthcare Provider Details

I. General information

NPI: 1205453776
Provider Name (Legal Business Name): LOCAL HEALTH SPECIALTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2020
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1198 NE DOUGLAS ST.
LEE'S SUMMIT MO
64086
US

IV. Provider business mailing address

330 N. FRANKLIN PO BOX 528
CUBA MO
65453
US

V. Phone/Fax

Practice location:
  • Phone: 816-607-5152
  • Fax: 816-607-5162
Mailing address:
  • Phone: 573-885-0885
  • Fax: 573-677-0567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: STEVEN DONNELLY
Title or Position: PRESIDENT
Credential:
Phone: 210-441-2036