DEDICATED MISSOURI HOLDING LLC NPI 1063153914

NPI Information

DEDICATED MISSOURI HOLDING, LLC is a non pharmacy dispensing site in Kansas City, MO. The provider is a site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) DEDICATED MISSOURI HOLDING, LLC NPI is 1063153914. The provider is registered as an organization entity type.

The provider's business location address is:

4400 E 39TH ST
KANSAS CITY, MO
ZIP 64128-818
Phone: (816) 791-7177
Fax: (816) 791-7190

The provider's authorized official is Mary Chen .
The authorized official title is Authorized Official and has the following contact phone number (305) 628-6117.

The CLIA number assigned to this NPI record is 26D2264009 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/5/2022 and was last updated on 4/5/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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