Provider Demographics
NPI:1336590470
Name:RTGIF INC
Entity Type:Organization
Organization Name:RTGIF INC
Other - Org Name:ASHCRAFT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIDAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-663-2258
Mailing Address - Street 1:503 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:S HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67505-1123
Mailing Address - Country:US
Mailing Address - Phone:620-663-2258
Mailing Address - Fax:620-663-8340
Practice Address - Street 1:503 N MAIN ST
Practice Address - Street 2:
Practice Address - City:S HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67505-1123
Practice Address - Country:US
Practice Address - Phone:620-663-2258
Practice Address - Fax:620-663-8340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-30
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2-13250333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201136740AMedicaid
2160843OtherPK