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NPI Code Detail

MEDICARE: DR. TIMOTHY J KRAUSE PHARM D

MEDICARE: DR. TIMOTHY J KRAUSE PHARM D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist118629MN

General Provider Information

NPI Number : 1619263738
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY J KRAUSE PHARM D
Provider Business Mailing Address
First Line : 6445 RICHFIELD PKWY
Second Line : T-2300
City : RICHFIELD
State : MN
Zip : 55423-6400
Country : US
Telephone Number : 612-252-0474
Fax Number : 612-252-0484
Provider Business Practice Location Address
First Line : 6445 RICHFIELD PKWY
Second Line : T-2300
City : RICHFIELD
State : MN
Zip : 55423-6400
Country : US
Telephone Number : 612-252-0474
Fax Number : 612-252-0484
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2011
Last Update Date : 06/27/2011

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