Healthcare Provider Details

I. General information

NPI: 1780837344
Provider Name (Legal Business Name): RICHARD KRUEGER R.PH,, PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2008
Last Update Date: 10/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3675 E BRITANNIA DR
TUCSON AZ
85706-5041
US

IV. Provider business mailing address

3675 E BRITANNIA DR
TUCSON AZ
85706-5041
US

V. Phone/Fax

Practice location:
  • Phone: 520-209-3000
  • Fax:
Mailing address:
  • Phone: 520-209-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License NumberS008779
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: