Kyle Jesse York, PHARM. D.
Individual provider Active NPI Pharmacist · Richland, MO
NPI 1922061001 · NPPES record last updated Jun 14, 2013
Key facts
- NPI
- 1922061001
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 200172890 (MO)
- Practice address
- 104 McClurg St
Richland, MO 65556-9998 - Phone
- (573) 765-3321
- NPI assigned
- Apr 10, 2006
- 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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200172890 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jonk LLC | Current | Accepting new patients | |
| Jonk LLC | Current | Accepting new patients |
Locations
104 E McClurg Ave
Richland, MO 65556
Phone (573) 765-3321
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 200172890 | MO | Yes |
Addresses
Primary practice location
104 McClurg St
Richland, MO 65556-9998
Mailing address
4210 State Road T
Stoutland, MO 65567-9188
Phone (417) 286-4516
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 359248507 | Medicaid | MO |
Other providers in Richland, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 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.