Provider Demographics
NPI:1053642884
Name:FEISTER, FRED C (RPH)
Entity Type:Individual
Prefix:MR
First Name:FRED
Middle Name:C
Last Name:FEISTER
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 1:1461 W MORNING WALK DR
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-8166
Mailing Address - Country:US
Mailing Address - Phone:317-467-1729
Mailing Address - Fax:
Practice Address - Street 1:1461 W MORNING WALK DR
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-8166
Practice Address - Country:US
Practice Address - Phone:317-467-1729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26011527A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist