Organization Name: | PRATER DRUG INC |
NPI Number: | 1386609972 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TOM G FRAZIER (STAFF PHARMACIST) |
Mailing Address: | 200 Church Street Salyersville |
State: | KY US |
Postal Code: | 414650068 |
Phone Number: | 6063493135 |
Fax Number: | 6063493512 |
NPI Enumeration Date: | 04/18/2006 |
NPI Last Update Date: | 06/04/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BC3200X |
License Number: | P00834 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KY |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Customized Equipment |
Taxonomy Definition: |