MEDICARE: HUBERT KOSSI EKPOH PHARMD

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	117035	KS
2	183500000X	Pharmacist	2015027479	MO

General Provider Information

NPI Number	:	1881163566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUBERT KOSSI EKPOH PHARMD

Provider Business Mailing Address
First Line	:	8956 NE 116TH PL
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64157-8119
Country	:	US
Telephone Number	:	816-217-3283
Fax Number	:

Provider Business Practice Location Address
First Line	:	5261 NE ANTIOCH RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64119-2646
Country	:	US
Telephone Number	:	816-448-4002
Fax Number	:

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

Provider Enumeration Date	:	11/25/2018
Last Update Date	:	11/25/2018

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