Provider Demographics
NPI:1710661442
Name:KRACH, ROBERT WILLIAM
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:WILLIAM
Last Name:KRACH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 STEPHENS CIR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:GA
Mailing Address - Zip Code:30217-4714
Mailing Address - Country:US
Mailing Address - Phone:706-812-3011
Mailing Address - Fax:
Practice Address - Street 1:24 STEPHENS CIR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:GA
Practice Address - Zip Code:30217-4714
Practice Address - Country:US
Practice Address - Phone:706-812-3011
Practice Address - Fax:706-948-0145
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-13
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies