Provider Demographics
NPI:1700180031
Name:PROPST, FOSTER DALE (RPH)
Entity Type:Individual
Prefix:MR
First Name:FOSTER
Middle Name:DALE
Last Name:PROPST
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 RIDGELAWN ROAD
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62442
Mailing Address - Country:US
Mailing Address - Phone:217-382-4004
Mailing Address - Fax:217-382-3476
Practice Address - Street 1:890 RIDGELAWN ROAD
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62442
Practice Address - Country:US
Practice Address - Phone:217-382-4004
Practice Address - Fax:217-382-3476
Is Sole Proprietor?:No
Enumeration Date:2010-12-30
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.0325141835P0018X
IN26013952A1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist