MEDICARE: FRAESE DRUG COMPANY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	210387	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2032542	OTHER		PK

General Provider Information

NPI Number	:	1184628166
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRAESE DRUG COMPANY INC

Provider Business Mailing Address
First Line	:	PO BOX 2458
Second Line	:
City	:	HUTCHINSON
State	:	KS
Zip	:	67504-2458
Country	:	US
Telephone Number	:	620-200-9325
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 N MAIN ST
Second Line	:
City	:	HUTCHINSON
State	:	KS
Zip	:	67501-5216
Country	:	US
Telephone Number	:	620-662-4498
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DON KAUFMAN
Credential	:	RPH
Telephone Number	:	620-622-4477

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	04/28/2016

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Directions to “FRAESE DRUG COMPANY INC ” Practice Location

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