Provider Demographics
NPI:1417542275
Name:BEKELE, SALEM (PHARMD)
Entity type:Individual
Prefix:
First Name:SALEM
Middle Name:
Last Name:BEKELE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 W 10TH ST APT 302
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64105-2206
Mailing Address - Country:US
Mailing Address - Phone:913-636-2208
Mailing Address - Fax:
Practice Address - Street 1:521 W 10TH ST APT 302
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64105-2206
Practice Address - Country:US
Practice Address - Phone:913-636-2208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-102837183500000X
MO2017029955183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist