MEDICARE: KEVIN FRANK PHARMACIST

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	183500000X	Pharmacist	17917	WI

General Provider Information

NPI Number	:	1770965105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN FRANK PHARMACIST

Provider Business Mailing Address
First Line	:	2138 DELAWARE AVE APT F
Second Line	:
City	:	GRAFTON
State	:	WI
Zip	:	53024-9446
Country	:	US
Telephone Number	:	309-371-7594
Fax Number	:

Provider Business Practice Location Address
First Line	:	2138 DELAWARE AVE APT F
Second Line	:
City	:	GRAFTON
State	:	WI
Zip	:	53024-9446
Country	:	US
Telephone Number	:	309-371-7594
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2015
Last Update Date	:	06/22/2015

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Directions to “ KEVIN FRANK PHARMACIST” Practice Location

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