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General NPI Number Information
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NPI Number | 1679718035
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Entity Type | Organization
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Legal Business Name | FOUR B CORP
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Dates
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Enumeration Date | 12/12/2008
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Last Update Date | 12/12/2008
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Provider Practice Location Address
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Address Line | 11930 COLLEGE BLVD
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City | OVERLAND PARK
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State | KS
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Zip | 66210-3943
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Country | US
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Telephone | 913-469-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 5300 SPEAKER RD
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City | KANSAS CITY
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State | KS
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Zip | 66106-1050
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Country | US
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Telephone | 913-573-1254
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY & WHOLE HEALTH
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Name | MICHAEL HALLIWELL
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Credential | RPH
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Telephone | 913-573-1254
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1800X
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Taxonomy Name | Corporate Health Clinic/Center
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License Number |
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License Number State |
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