Provider Demographics
NPI:1518686955
Name:PRATT'S REXALL DRUGS, INC
Entity Type:Organization
Organization Name:PRATT'S REXALL DRUGS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:NEAL
Authorized Official - Last Name:WILLIMANN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:573-237-3321
Mailing Address - Street 1:100 DWAYNE VONBEHREN DRIVE
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:MO
Mailing Address - Zip Code:63068
Mailing Address - Country:US
Mailing Address - Phone:573-237-3321
Mailing Address - Fax:573-237-2005
Practice Address - Street 1:100 DWAYNE VONBEHREN DRIVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:MO
Practice Address - Zip Code:63068
Practice Address - Country:US
Practice Address - Phone:573-237-3321
Practice Address - Fax:573-237-2005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy