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Individual

DERICK MIRANDA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARM.D.

Contact information

Practice address
2301 HOLMES ST, DEPARTMENT OF PHARMACY, KANSAS CITY, MO 64108-2640
(816) 404-4168
Mailing address
2301 HOLMES ST, DEPARTMENT OF PHARMACY, KANSAS CITY, MO 64108-2640
(816) 404-4168

Taxonomy

Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
2011026603
MO

Other

Enumeration date
06/30/2014
Last updated
06/30/2014
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