NPI | 1184628166 |
---|---|
Doing Business As | FRAESE DRUG AND SODA FOUNTAIN GRILL |
Entity Type | Organization |
Authorized Contact | DON KAUFMAN Owner/President 620-622-4477 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: KS 210387) |
Additional Taxonomies | 333600000X Pharmacy |
Enumeration Date | 2005-06-08 |
Last Update Date | 2016-04-28 |