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Organization

STAKER'S SERVICE DRUGS,INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RICHARD THOMAS STAKER (PRESIDENT)
(740) 353-1135
Entity
Organization

Contact information

Practice address
826 CHILLICOTHE ST, PORTSMOUTH, OH 45662-4028
(740) 353-1135
(740) 353-4109
Mailing address
826 CHILLICOTHE ST, PORTSMOUTH, OH 45662-4028
(740) 353-1135
(740) 353-4109

Taxonomy

Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
333600000X
Pharmacy
Primary
020113850
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
54027818
KY
05
8365808
OH
Enumeration date
06/01/2005
Last updated
03/02/2010
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