MEDICARE: MR. JEFFREY AARON KRAUSE 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	03-2-23344	OH

General Provider Information

NPI Number	:	1417920182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JEFFREY AARON KRAUSE RPH

Provider Business Mailing Address
First Line	:	3760 CORNERSTONE LN
Second Line	:
City	:	DUNCAN FALLS
State	:	OH
Zip	:	43734-9700
Country	:	US
Telephone Number	:	740-674-4390
Fax Number	:

Provider Business Practice Location Address
First Line	:	105 N KENNEBEC AVE
Second Line	:
City	:	MC CONNELSVILLE
State	:	OH
Zip	:	43756-1254
Country	:	US
Telephone Number	:	740-962-2552
Fax Number	:	740-962-2730

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

Provider Enumeration Date	:	02/10/2006
Last Update Date	:	07/08/2007

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