MEDICARE: COSENTINO ENTERPRISES INC

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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	005986	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295895233
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COSENTINO ENTERPRISES INC

Provider Business Mailing Address
First Line	:	3901 W 83RD ST
Second Line	:
City	:	PRAIRIE VILLAGE
State	:	KS
Zip	:	66208-5308
Country	:	US
Telephone Number	:	913-749-1511
Fax Number	:	913-905-3027

Provider Business Practice Location Address
First Line	:	1101 S 7 HWY
Second Line	:
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64014-3204
Country	:	US
Telephone Number	:	816-229-3252
Fax Number	:	816-229-1726

Authorized Official
Title or Position	:	DIRECTOR OF PHARMACY
Name	:	FRANK WOLFF
Credential	:
Telephone Number	:	913-749-1511

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	01/25/2022

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Directions to “COSENTINO ENTERPRISES INC ” Practice Location

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