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General NPI Number Information
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NPI Number | 1356525539
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Entity Type | Individual
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Provider Name | BRADLEY TODD KUNKEL RPH
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Gender | Male
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Dates
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Enumeration Date | 12/24/2007
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Last Update Date | 12/24/2007
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Provider Practice Location Address
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Address Line | 101 W 92 HWY STE. A RED CROSS PHARMACY
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City | KEARNEY
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State | MO
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Zip | 64060-7591
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Country | US
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Telephone | 816-635-4485
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Fax | 816-628-4649
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Provider Business Mailing Address
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Address Line | 101 WEST 92 HWY RED CROSS PHARMACY
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City | KEARNEY
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State | MO
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Zip | 64068-7591
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Country | US
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Telephone | 816-635-4485
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Fax | 816-628-4649
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 042756
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License Number State | MO
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