Organization
JERABEN INC
Active
Organization
JERABEN INC
Active
Other names
MILLS DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM FRANEY RPH (OWNER)
(270) 683-1571
Entity
Organization
Contact information
Practice address
1000 E 4TH ST, OWENSBORO, KY 42303-3323
(270) 683-1571
(270) 926-4619
Mailing address
1000 E 4TH ST, OWENSBORO, KY 42303-3323
(270) 683-1571
(270) 926-4619
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P06639
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1807669
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
54002191
—
KY
Enumeration date
11/03/2006
Last updated
06/15/2011
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