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General NPI Number Information
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NPI Number | 1801514690
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Entity Type | Individual
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Provider Name | COLE MICHAEL KITTERMAN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/17/2022
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Last Update Date | 08/17/2022
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Provider Practice Location Address
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Address Line | 1510 OHIO ST
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City | AUGUSTA
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State | KS
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Zip | 67010-2189
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Country | US
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Telephone | 316-775-5456
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Fax | 316-775-4108
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Provider Business Mailing Address
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Address Line | 208 S ONEWOOD DR
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City | ANDOVER
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State | KS
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Zip | 67002-8815
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Country | US
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Telephone | 316-616-7957
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Fax |
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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 | 1-107191
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License Number State | KS
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