Aetna RX Home Delivery, LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

2003001979 Issued in MO

Legal business name

AETNA RX HOME DELIVERY, LLC

Practice address

10991 NW Airworld Dr
Kansas City, MO 64153-2011

Phone

(866) 612-3862

NPI assigned

Feb 28, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. John P Dehaemers, PHARM D

Title

Dir, Pharmacist - in -Charge

Phone

(959) 299-2941

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Aetna RX Home Delivery LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Aetna RX Home Delivery, LLC

  • Mail Order Pharmacy
  • Kansas City, MO
  • NPI 1699925271
  NPD tax ID
• Aetna RX Home Delivery

  • Mail Order Pharmacy
  • Plantation, FL
  • NPI 1427096809
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1033185186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10991 NW AIRWORLD DR",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641532011",
            "telephone_number": "866-612-3862",
            "fax_number": "877-270-3317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10991 NW AIRWORLD DR",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641532011",
            "telephone_number": "866-612-3862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AETNA RX HOME DELIVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-28",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "DEHAEMERS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DIR, PHARMACIST - IN -CHARGE",
        "authorized_official_telephone_number": "959-299-2941",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MO",
            "license": "2003001979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI LICENSE",
            "identifier": "2003001979",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jeremy T Affolter, MD
• Maggie Affolter, RN, FNP

• Pharmacy in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.