Basic Information
| Provider Information | |||||||||
| NPI: | 1255442133 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCCOMBS | ||||||||
| FirstName: | TRACY | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHARM. D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2831 N 99TH ST | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 661094313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9133346837 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4401 WORNALL RD | ||||||||
| Address2: | B LEVEL MAIN PHARMACY | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641113220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8169322000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 11/23/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P0018X | 2008000710 | MO | Y | Pharmacy Service Providers | Pharmacist | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P1200X | 2008000710 | MO | N | Pharmacy Service Providers | Pharmacist | Pharmacotherapy | 183500000X | 2008000710 | MO | N | Pharmacy Service Providers | Pharmacist | 1835G0303X | 2008000710 | MO | N | Pharmacy Service Providers | Pharmacist | Geriatric | 1835P1300X | 2008000710 | MO | N | Pharmacy Service Providers | Pharmacist | Psychiatric |
No ID Information.