Travis Goff, PHARMD
Individual provider Active NPI Pharmacist · Bonner Springs, KS
NPI 1417544784 · NPPES record last updated Dec 21, 2020
Key facts
- NPI
- 1417544784
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 1-14102 (KS)
- Practice address
- 501 Commercial Dr
Bonner Springs, KS 66012-9617 - Phone
- (913) 422-1040
- NPI assigned
- Dec 21, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-14102 | KS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Queen Enterprises L L C | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 1-14102 | KS | Yes |
Addresses
Primary practice location
501 Commercial Dr
Bonner Springs, KS 66012-9617
Mailing address
501 Commercial Dr
Bonner Springs, KS 66012-9617
Phone (913) 422-1040
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pharmacy10@epricechopper.com | Direct |
Other providers in Bonner Springs, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 21, 2020. 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.