Nathan Straeter

Individual provider Active NPI Pharmacist · Caruthersville, MO

NPI 1134573017 · NPPES record last updated Apr 18, 2016

Key facts

NPI
1134573017
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
2015024636 (MO)
Practice address
State Highway 84 West
Caruthersville, MO 63830
Phone
(573) 333-0073
NPI assigned
Apr 18, 2016
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2015024636MOMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2015024636 MO Yes

Addresses

Primary practice location

State Highway 84 West
Caruthersville, MO 63830

Mailing address

State Highway 84 West
Caruthersville, MO 63830
Phone (573) 333-0073

Other providers in Caruthersville, MO

All providers in Caruthersville, MO · Pharmacist in Missouri

Sources for this page

Verify at the official NPI Registry.