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General NPI Number Information
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NPI Number | 1295010270
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Entity Type | Individual
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Provider Name | ROBERT LEE KRZMARZICK RPH
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Gender | Male
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Dates
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Enumeration Date | 10/20/2011
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Last Update Date | 10/20/2011
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Provider Practice Location Address
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Address Line | 5949 FAIRWOOD LN
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City | MINNETONKA
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State | MN
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Zip | 55345-6534
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Country | US
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Telephone | 952-934-4598
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Fax |
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Provider Business Mailing Address
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Address Line | 8240 FLYING CLOUD DR
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City | EDEN PRAIRIE
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State | MN
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Zip | 55344-5316
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Country | US
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Telephone | 952-252-1112
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 111785
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License Number State | MN
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