Paul Logan Aldeguer, RPH
Individual provider Active NPI Pharmacist · Shawnee, KS
NPI 1346580339 · NPPES record last updated Feb 27, 2013
Key facts
- NPI
- 1346580339
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 11935 (KS)
- Practice address
- 12010 W 63Rd St
Shawnee, KS 66216-1867 - Phone
- (913) 268-8150
- Fax
- (913) 268-8479
- NPI assigned
- Feb 27, 2013
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11935 | KS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Four B Corp | Past | Accepting new patients | |
| Four B Corp | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11935 | KS | Yes |
Addresses
Primary practice location
12010 W 63Rd St
Shawnee, KS 66216-1867
Mailing address
12010 W 63Rd St
Shawnee, KS 66216-1867
Phone (913) 268-8150
Other providers in Shawnee, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.