Provider Demographics
NPI:1912510066
Name:KRATZER'S HOMETOWN PHARMACY MAINEVILLE
Entity type:Organization
Organization Name:KRATZER'S HOMETOWN PHARMACY MAINEVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:KRATZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-382-0081
Mailing Address - Street 1:179 W LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:45177-2180
Mailing Address - Country:US
Mailing Address - Phone:937-725-0388
Mailing Address - Fax:
Practice Address - Street 1:6647 S STATE ROUTE 48
Practice Address - Street 2:
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039-9758
Practice Address - Country:US
Practice Address - Phone:513-880-0023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy