Basic Information
Provider Information
NPI: 1003150848
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZIELINSKI
FirstName: NICHOLAS
MiddleName: C
NamePrefix: DR.
NameSuffix:  
Credential: PHARMD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2641 SW WALNUT ST
Address2:  
City: BLUE SPRINGS
State: MO
PostalCode: 640153316
CountryCode: US
TelephoneNumber: 5202512706
FaxNumber:  
Practice Location
Address1: 4801 E LINWOOD BLVD
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641282226
CountryCode: US
TelephoneNumber: 8168614700
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/17/2012
LastUpdateDate: 03/29/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/29/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000XS019570AZY Pharmacy Service ProvidersPharmacist 
183500000X2013006897MON Pharmacy Service ProvidersPharmacist 

No ID Information.


Home