MEDICARE: DR. MICHAEL DUANE KROHN 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
1	183500000X	Pharmacist	14967	NV

General Provider Information

NPI Number	:	1881916492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL DUANE KROHN PHARM.D

Provider Business Mailing Address
First Line	:	732 S RACETRACK RD
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89015-8539
Country	:	US
Telephone Number	:	702-565-7446
Fax Number	:	702-564-4041

Provider Business Practice Location Address
First Line	:	732 SOUTH RACETRACK ROAD
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89015-8539
Country	:	US
Telephone Number	:	702-565-7446
Fax Number	:	702-564-4041

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2010
Last Update Date	:	02/23/2010

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