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General NPI Number Information
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NPI Number | 1396141180
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Entity Type | Organization
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Legal Business Name | COSENTINO ENTERPRISES INC
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Dates
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Enumeration Date | 11/06/2014
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Last Update Date | 10/14/2020
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Provider Practice Location Address
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Address Line | 15700 N US HIGHWAY 169 STE E
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City | SMITHVILLE
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State | MO
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Zip | 64089-9315
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Country | US
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Telephone | 816-532-6140
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Fax | 816-532-6145
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Provider Business Mailing Address
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Address Line | 3901 W 83RD ST
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66208-5308
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Country | US
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Telephone | 913-749-1511
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Fax | 913-905-3027
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | FRANK WOLFF
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Credential |
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Telephone | 913-749-1511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 2014039505
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License Number State | MO
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