Provider Demographics
NPI:1558645754
Name:FRANKE, LOGAN M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LOGAN
Middle Name:M
Last Name:FRANKE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 E PETTIT AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46806
Mailing Address - Country:US
Mailing Address - Phone:260-744-4351
Mailing Address - Fax:
Practice Address - Street 1:222 E PETTIT AVE
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46806
Practice Address - Country:US
Practice Address - Phone:260-744-4351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26024179A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist