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Shawnee Mission Medical Center Inc

Organization Active NPI Community/Retail Pharmacy · Shawnee Mission, KS

NPI 1720146970 · NPPES record last updated Jul 23, 2018

Key facts

NPI
1720146970
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
209764 (KS)
Legal business name
SHAWNEE MISSION MEDICAL CENTER INC
Practice address
9100 W. 74TH St
Shawnee Mission, KS 66204
Phone
(913) 789-3976
Fax
(913) 789-6730
NPI assigned
Dec 4, 2006
Organization subpart
No

Authorized official

Name
Michelle R Martin, R.PH.
Title
Pic/Pharmacy Manager
Phone
(913) 789-3976

Corporate family (same tax ID) 13

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

National Provider Directory

Tax ID family
Mid America Physicians (14 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 209764 KS Yes

Addresses

Primary practice location

9100 W. 74TH St
Shawnee Mission, KS 66204

Mailing address

9100 W. 74TH St
Shawnee Mission, KS 66204
Phone (913) 789-3976

Other identifiers

IdentifierTypeStateIssuer
2027055OtherPK
100007000BMedicaidKS

Other names

  • MEDICAL CENTER PHARMACY Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 23, 2018.

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532304000000",
    "number": "1720146970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 W. 74TH ST",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "66204",
            "telephone_number": "913-789-3976",
            "fax_number": "913-789-6730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 W. 74TH ST",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "66204",
            "telephone_number": "913-789-3976",
            "fax_number": "913-789-6730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWNEE MISSION MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2018-07-23",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PIC/PHARMACY MANAGER",
        "authorized_official_telephone_number": "913-789-3976",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KS",
            "license": "209764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2027055",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100007000B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICAL CENTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MEDICAL CENTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shawnee Mission, KS

All providers in Shawnee Mission, KS · Community/Retail Pharmacy in Kansas

Sources for this page

Verify at the official NPI Registry.