Provider Demographics
NPI:1851673693
Name:RATH, PHILIP LEON (RPH)
Entity type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:LEON
Last Name:RATH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-1916
Mailing Address - Country:US
Mailing Address - Phone:316-281-9356
Mailing Address - Fax:316-282-9335
Practice Address - Street 1:1300 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-1916
Practice Address - Country:US
Practice Address - Phone:316-281-9356
Practice Address - Fax:316-282-9335
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS08986183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist