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Individual

MR. MANNIE TRUJILLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARM. D.

Contact information

Practice address
1000 NE SAM WALTON LN, LEES SUMMIT, MO 64086-8426
(214) 673-0941
Mailing address
1000 NW SAM WALTON LN., LEE'S SUMMIT, MO 64086
(214) 673-0941

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
1-16984
KS
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
2014042861
MO
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
46176
TX

Other

Enumeration date
09/21/2015
Last updated
09/21/2015
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