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General NPI Number Information
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NPI Number | 1427729615
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Entity Type | Individual
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Provider Name | MICAH COLE KENDALL
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Gender | Male
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Dates
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Enumeration Date | 09/27/2021
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 112 S MAIN ST
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City | GREENSBURG
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State | KS
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Zip | 67054-1724
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Country | US
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Telephone | 620-723-3112
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Fax | 620-723-3421
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Provider Business Mailing Address
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Address Line | 675 3RD ST
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City | OSCEOLA
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State | MO
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Zip | 64776-2934
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Country | US
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Telephone | 417-646-2301
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Fax | 417-646-2456
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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 | 2021027219
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 1-103795
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License Number State | KS
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