ACTIVE LIFESTYLE PHARMACY LLC (NPI# 1811536683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811536683 |
| Entity Type | Organization |
| Organization Name | ACTIVE LIFESTYLE PHARMACY LLC |
| Practice Address |
7800 Foster St Overland Park KS 66204-2955 |
| Practice Telephone | 9137308731 |
| Practice Fax Number | 8448420014 |
| Mailing Telephone | 9137308731 |
| Mailing Fax Number | 8448420014 |
| Enumeration Date | 2019-12-27 |
| Last Update Date | 2019-12-27 |
| Authorized Official Name | JACOB M LICKTEIG (PRESIDENT) |
| Authorized Official Telephone | 7857603839 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| Street Address |
7800 FOSTER ST |
| City | OVERLAND PARK |
| State | KS |
| Zip Code | 66204-2955 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578559332 | Advance Diabetic Supply, Inc | Durable Medical Equipment & Medical Supplies | 7800 Foster St, Overland Park, KS 66204 | 2005-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326652405 | Avenue 81 Iaop | Assisted Living Facility | 8055 Metcalf Ave, Overland Park, KS 66204 | 2020-09-04 |
| 1487160255 | Femme Focus, L.L.C. | Clinic/Center | 7927 Floyd, Rm 5, Home Family Holistic Center, Overland Park, KS 66204 | 2017-12-15 |
| 1427577469 | Linda Kay Mufich-knopp | Physical Therapist | Femme Focus, L.L.C. In The Home Family Holistic Center, 7927 Floyd Street, Suite 5, Overland Park, KS 66204 | 2017-09-11 |
| 1700304789 | Kalli Dee Karmann | Occupational Therapy Assistant | 6814 W 72nd St, Overland Park, KS 66204 | 2017-08-30 |
| 1164951786 | Daniel Collins | Physical Therapist | 10000 W. 75th St. Ste. 250, Merriam, KS 66204 | 2017-06-07 |
| 1942686530 | Anna Katheryn Grantham | Speech-Language Pathologist | 10000 W. 75th St., Suite 250, Merriam, KS 66204 | 2015-08-05 |
| 1700262680 | Maple Hills Healthcare, Inc. | Skilled Nursing Facility | 7600 Antioch Rd, Overland Park, KS 66204 | 2015-08-03 |
| 1104211085 | John Brainard | Pediatrics | 8901 W 74th St Ste 10, Shawnee Mission, KS 66204 | 2015-03-30 |
| 1477941318 | Shelley Watts | Occupational Therapy Assistant | 6712 W 72nd Street, Overland Park, KS 66204 | 2014-12-30 |
| 1578963369 | James Aaron Mitchum | Counselor | 7923 Santa Fe Dr, Overland Park, KS 66204 | 2014-08-28 |
| Find all providers in zip 66204 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841807120 | Optumrx, Inc. | Pharmacy | 6800 W 115th Street, Suite 600, Overland Park, KS 66211-9838 | 2020-09-30 |
| 1184145237 | Ge Gao | Pharmacy | 10126 W 119th St, Overland Park, KS 66213-1461 | 2017-06-29 |
| 1629448022 | Midwest Biologics, Inc. | Pharmacy | 16124 Foster St, Overland Park, KS 66085-8417 | 2015-09-29 |
| 1598850232 | Howard Stark Professional Pharmacy | Pharmacy | 5701 W 119th St Ste 125, Overland Park, KS 66209-3721 | 2006-10-04 |
| 1144327636 | Kansas Cvs Pharmacy, L.L.C. | Pharmacy | 9501 Nall Ave, Overland Park, KS 66207-2949 | 2006-09-19 |
| 1225148844 | Costco Wholesale Corporation | Pharmacy | 12221 Blue Valley Pkwy, Overland Park, KS 66213 | 2006-08-30 |
| 1417963059 | Walgreen Co | Pharmacy | 8681 W 135th St, Overland Park, KS 66223-1215 | 2006-08-01 |
| 1548282288 | Kansas Cvs Pharmacy LLC | Pharmacy | 12200 Blue Valley Pkwy, Overland Park, KS 66213-2639 | 2006-07-24 |
| 1669408050 | Hy-vee, Inc. | Pharmacy | 10118 W 119th St, Overland Park, KS 66213-1600 | 2006-06-25 |
| 1639113004 | Kansas Cvs Pharmacy LLC | Pharmacy | 12691 Antioch Rd, Overland Park, KS 66213-1701 | 2006-06-16 |
| Find all providers in OVERLAND PARK | ||||
| City | OVERLAND PARK |
| Zip Code | 66204 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.