Healthcare Provider Details

I. General information

NPI: 1700434214
Provider Name (Legal Business Name): KRATZER PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2019
Last Update Date: 08/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 S BREIEL BLVD
MIDDLETOWN OH
45044-6201
US

IV. Provider business mailing address

179 W LOCUST ST
WILMINGTON OH
45177-2180
US

V. Phone/Fax

Practice location:
  • Phone: 513-217-6222
  • Fax:
Mailing address:
  • Phone: 937-382-0081
  • Fax: 937-655-8774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

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