MEDICARE: MR. BILL JEROME KRONENBERG RPH

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	06004	NV

General Provider Information

NPI Number	:	1356571707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BILL JEROME KRONENBERG RPH

Provider Business Mailing Address
First Line	:	14625 N CAMEO DR
Second Line	:
City	:	SUN CITY
State	:	AZ
Zip	:	85351-2406
Country	:	US
Telephone Number	:	623-399-8217
Fax Number	:	623-399-8217

Provider Business Practice Location Address
First Line	:	14625 N CAMEO DR
Second Line	:
City	:	SUN CITY
State	:	AZ
Zip	:	85351-2406
Country	:	US
Telephone Number	:	623-399-8217
Fax Number	:	623-399-8217

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

Provider Enumeration Date	:	07/20/2009
Last Update Date	:	07/20/2009

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