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General NPI Number Information
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NPI Number | 1790068997
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Entity Type | Individual
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Provider Name | BROOKE KING PHARM D
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Gender | Female
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Dates
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Enumeration Date | 09/23/2011
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Last Update Date | 09/23/2011
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Provider Practice Location Address
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Address Line | 4330 SHAWNEE MISSION PKWY STE 308
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City | FAIRWAY
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State | KS
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Zip | 66205-2522
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Country | US
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Telephone | 913-236-7271
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Fax | 913-236-8929
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Provider Business Mailing Address
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Address Line | 25575 METCALF RD
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City | LOUISBURG
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State | KS
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Zip | 66053-6319
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Country | US
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Telephone | 913-575-3095
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Fax | 913-236-8929
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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 | 2008029238
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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 | 13493
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License Number State | KS
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