Healthcare Provider Details

I. General information

NPI: 1619972189
Provider Name (Legal Business Name): KRATZER'S PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

912 CHERRY ST
BLANCHESTER OH
45107-1318
US

IV. Provider business mailing address

912 CHERRY ST
BLANCHESTER OH
45107-1318
US

V. Phone/Fax

Practice location:
  • Phone: 937-783-5444
  • Fax: 937-783-5446
Mailing address:
  • Phone: 937-783-5444
  • Fax: 937-783-5446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number StateOH

VIII. Authorized Official

Name: MR. MARK A KRATZER
Title or Position: OWNER
Credential:
Phone: 937-783-5444