Provider Demographics
NPI:1437224250
Name:DANHAUER DRUG LTC
Entity Type:Organization
Organization Name:DANHAUER DRUG LTC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:W
Authorized Official - Last Name:DANHAUER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:270-570-0385
Mailing Address - Street 1:328 FREDERICA STREET
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-3005
Mailing Address - Country:US
Mailing Address - Phone:270-684-0129
Mailing Address - Fax:270-684-2396
Practice Address - Street 1:328 FREDERICA STREET
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-3005
Practice Address - Country:US
Practice Address - Phone:270-684-0129
Practice Address - Fax:270-684-2396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1827712OtherNABP