Basic Information
Provider Information | |||||||||
NPI: | 1265719611 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | CUMMINGS | ||||||||
FirstName: | AMY | ||||||||
MiddleName: | D | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | PHARM.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | RARRICK | ||||||||
OtherFirstName: | AMY | ||||||||
OtherMiddleName: | D | ||||||||
OtherNamePrefix: | DR. | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | PHARM.D. | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 4801 E LINWOOD BLVD | ||||||||
Address2: |   | ||||||||
City: | KANSAS CITY | ||||||||
State: | MO | ||||||||
PostalCode: | 641282226 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8169222500 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 2200 SW GAGE BLVD | ||||||||
Address2: | PHARMACY SERVICES 119 | ||||||||
City: | TOPEKA | ||||||||
State: | KS | ||||||||
PostalCode: | 666220001 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7853503111 | ||||||||
FaxNumber: | 7853504486 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 11/14/2011 | ||||||||
LastUpdateDate: | 07/13/2012 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 2011027490 | MO | N |   | Pharmacy Service Providers | Pharmacist |   | 1835P1200X | 2011027490 | MO | Y |   | Pharmacy Service Providers | Pharmacist | Pharmacotherapy |
No ID Information.