Organization
SAMUEL U. RODGERS HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAYBELLE M BOWENS BS (PHARMACY DIRECTOR)
(816) 889-4652
Entity
Organization
Contact information
Practice address
825 EUCLID AVE, KANSAS CITY, MO 64124
(816) 889-4652
(816) 842-6227
Mailing address
825 EUCLID AVE, KANSAS CITY, MO 64124-2323
(816) 889-4652
(816) 842-6227
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
28254
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2608086
NCPDP
—
05
—
600588412
—
MO
Enumeration date
05/17/2007
Last updated
06/07/2018
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