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General NPI Number Information
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NPI Number | 1336137017
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Entity Type | Individual
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Provider Name | DAVID RUSSELL GUTEKUNST RPH
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Gender | Male
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Dates
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Enumeration Date | 10/07/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2700 SHELLY RD
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City | HARLEYSVILLE
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State | PA
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Zip | 19438-1281
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Country | US
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Telephone | 215-513-3053
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Fax | 215-513-3052
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Provider Business Mailing Address
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Address Line | 2700 SHELLY RD
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City | HARLEYSVILLE
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State | PA
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Zip | 19438-1201
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Country | US
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Telephone | 215-513-3053
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Fax | 215-513-3052
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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 | RP031185L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | A10002778
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License Number State | DE
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