Provider Demographics
NPI:1679983217
Name:OKARA, AMOS
Entity type:Individual
Prefix:
First Name:AMOS
Middle Name:
Last Name:OKARA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9430 BLUE RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64138-3846
Mailing Address - Country:US
Mailing Address - Phone:816-765-5279
Mailing Address - Fax:
Practice Address - Street 1:9430 BLUE RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64138-3846
Practice Address - Country:US
Practice Address - Phone:816-765-5279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013042221183500000X
KS1-16105183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist