Provider Demographics
NPI:1033780168
Name:PRATHER PHARMACY HOLDINGS, LLC
Entity type:Organization
Organization Name:PRATHER PHARMACY HOLDINGS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PRATHER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:734-777-7206
Mailing Address - Street 1:6725 W CENTRAL AVE STE B
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-1154
Mailing Address - Country:US
Mailing Address - Phone:419-841-3833
Mailing Address - Fax:
Practice Address - Street 1:6725 W CENTRAL AVE STE B
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-1154
Practice Address - Country:US
Practice Address - Phone:419-841-3833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NUNYA BUSINESS SYSTEMS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy