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NPI Code Detail

MEDICARE: BRONWYN CELEST BURBRIDGE

MEDICARE: BRONWYN CELEST BURBRIDGE
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
1183500000XPharmacist1999140899MO

General Provider Information

NPI Number : 1346461217
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRONWYN CELEST BURBRIDGE
Provider Business Mailing Address
First Line : 12625 SLATER ST
Second Line :
City : OVERLAND PARK
State : KS
Zip : 66213-4722
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 453 E RED BRIDGE RD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64131-4038
Country : US
Telephone Number : 816-942-2800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2007
Last Update Date : 07/08/2007

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Directions to “ BRONWYN CELEST BURBRIDGE ” Practice Location

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