Healthcare Provider Details

I. General information

NPI: 1811469927
Provider Name (Legal Business Name): JOSEPH SAUPPEE PHARMD, MBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/31/2018
Last Update Date: 12/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 NW VICTORIA DR
LEES SUMMIT MO
64086-4709
US

IV. Provider business mailing address

255 NW VICTORIA DR
LEES SUMMIT MO
64086-4709
US

V. Phone/Fax

Practice location:
  • Phone: 855-937-7273
  • Fax:
Mailing address:
  • Phone: 855-937-7273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2009029567
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: