MEDICARE: MS. MARILYN SUE BAKER RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	040050	MO

General Provider Information

NPI Number	:	1104148717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARILYN SUE BAKER RPH

Provider Business Mailing Address
First Line	:	7701 N MERSINGTON AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64119-1265
Country	:	US
Telephone Number	:	816-468-8762
Fax Number	:

Provider Business Practice Location Address
First Line	:	2821 NE VIVION RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64119-2515
Country	:	US
Telephone Number	:	816-452-5300
Fax Number	:	816-454-1541

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2010
Last Update Date	:	02/23/2010

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