MEDICARE: CANDI FAULKNER RPH, BS PHARM

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	1835P2201X	Ambulatory Care Pharmacist	043960	MO

General Provider Information

NPI Number	:	1922603521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANDI FAULKNER RPH, BS PHARM

Provider Business Mailing Address
First Line	:	921 MAIN ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64105-2021
Country	:	US
Telephone Number	:	816-842-2514
Fax Number	:

Provider Business Practice Location Address
First Line	:	921 MAIN ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64105-2021
Country	:	US
Telephone Number	:	816-842-2514
Fax Number	:

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

Provider Enumeration Date	:	12/01/2020
Last Update Date	:	12/01/2020

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