Healthcare Provider Details

I. General information

NPI: 1780744920
Provider Name (Legal Business Name): COSENTINO ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 01/05/2024
Certification Date: 01/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

937 NE WOODS CHAPEL RD
LEES SUMMIT MO
64064-1989
US

IV. Provider business mailing address

13180 METCALF AVE STE 100
OVERLAND PARK KS
66213-2810
US

V. Phone/Fax

Practice location:
  • Phone: 816-246-7300
  • Fax: 816-875-1015
Mailing address:
  • Phone: 913-749-1511
  • Fax: 913-905-3027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2002026743
License Number StateMO

VIII. Authorized Official

Name: FRANKLIN E WOLFF
Title or Position: DIRECTOR OF PHARMACY
Credential:
Phone: 913-749-1511