Mr Kenneth C Petta, RPH is a
Pharmacist based in Troup, Texas. Mr Kenneth C Petta is licensed to practice in Texas (license number 29476) and his current practice location is
53 W Twin Creeks Trl, Troup, Texas. He can be reached at his office (for appointments etc.) via phone at
(903) 842-4209.
NPI number for Mr Kenneth C Petta is 1871877373 and his current mailing address is 53 W Twin Creeks Trl, Troup, Texas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1871877373.
Healthcare Provider's Profile
| Full Name | Mr Kenneth C Petta |
|---|
| Gender | Male |
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| Speciality | Pharmacist |
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| Location | 53 W Twin Creeks Trl, Troup, Texas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1871877373
- Provider Enumeration Date: 10/03/2011
- Last Update Date: 10/03/2011
Medical Identifiers
Medical identifiers for Mr Kenneth C Petta such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1871877373 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 183500000X | Pharmacist | 29476 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Kenneth C Petta is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Kenneth C Petta, RPH
53 W Twin Creeks Trl,
Troup, TX 75789-6702
Ph: (903) 842-4209 | Mr Kenneth C Petta, RPH
53 W Twin Creeks Trl,
Troup, TX 75789-6702
Ph: (903) 842-4209 |
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