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Organization
AETNA RX HOME DELIVERY, LLC
Active
Organization
AETNA RX HOME DELIVERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN P DEHAEMERS PHARM D (DIR, PHARMACIST - IN -CHARGE)
(959) 299-2941
Entity
Organization
Contact information
Practice address
10991 NW AIRWORLD DR, KANSAS CITY, MO 64153-2011
(866) 612-3862
Mailing address
10991 NW AIRWORLD DR, KANSAS CITY, MO 64153-2011
(866) 612-3862
(877) 270-3317
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
2003001979
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2003001979
MISSOURI LICENSE
MO
Enumeration date
02/28/2006
Last updated
03/07/2023
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