Provider Demographics
NPI:1144302944
Name:ARNOLD PHARMACY INC
Entity type:Organization
Organization Name:ARNOLD PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER,PIC,AO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:PRENGER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:419-586-2238
Mailing Address - Street 1:PO BOX 393
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:OH
Mailing Address - Zip Code:45822-0393
Mailing Address - Country:US
Mailing Address - Phone:419-586-2238
Mailing Address - Fax:419-584-1721
Practice Address - Street 1:101 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:OH
Practice Address - Zip Code:45822-2201
Practice Address - Country:US
Practice Address - Phone:419-586-2238
Practice Address - Fax:419-584-1721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
OH0201732003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2072885OtherPK
OH0381171Medicaid
OH0381171Medicaid