Healthcare Provider Details

I. General information

NPI: 1427234350
Provider Name (Legal Business Name): COSENTINO GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2008
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 W FOXWOOD DR
RAYMORE MO
64083-7201
US

IV. Provider business mailing address

13180 METCALF AVE
OVERLAND PARK KS
66213-2815
US

V. Phone/Fax

Practice location:
  • Phone: 816-265-6134
  • Fax: 816-265-6136
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 Number2008000044
License Number StateMO

VIII. Authorized Official

Name: BRENTON FORESEE
Title or Position: DIRECTOR OF PHARMACY
Credential:
Phone: 913-749-1511