Organization Name: | ANTIS PHARMACY,INC |
NPI Number: | 1346387859 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK D ANTIS (PRESIDENT) |
Mailing Address: | 89 Second St Vanceburg |
State: | KY US |
Postal Code: | 411795439 |
Phone Number: | 6067962932 |
Fax Number: | 6067962124 |
NPI Enumeration Date: | 01/31/2007 |
NPI Last Update Date: | 05/26/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BP3500X |
License Number: | P06079 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KY |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Parenteral & Enteral Nutrition |
Taxonomy Definition: |