MEDICARE: KENNETH CHRIS MOYER R.PH.

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	08677	KS

General Provider Information

NPI Number	:	1215037809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH CHRIS MOYER R.PH.

Provider Business Mailing Address
First Line	:	7222 W 80TH ST
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66204-3718
Country	:	US
Telephone Number	:	913-341-7244
Fax Number	:

Provider Business Practice Location Address
First Line	:	7222 W 80TH ST
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66204-3718
Country	:	US
Telephone Number	:	913-341-7244
Fax Number	:

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

Provider Enumeration Date	:	09/23/2006
Last Update Date	:	07/08/2007

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