Healthcare Provider Details

I. General information

NPI: 1952943375
Provider Name (Legal Business Name): KRATZER PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2019
Last Update Date: 10/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 W MAIN ST STE D
LEBANON OH
45036-2098
US

IV. Provider business mailing address

179 W LOCUST ST
WILMINGTON OH
45177-2180
US

V. Phone/Fax

Practice location:
  • Phone: 513-228-1800
  • Fax:
Mailing address:
  • Phone: 937-382-0081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MARK A KRATZER
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 937-382-0081