MEDICARE: DR. JOHN KUROWSKY II 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	I 06056	AZ

General Provider Information

NPI Number	:	1538377494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN KUROWSKY II RPH

Provider Business Mailing Address
First Line	:	1716 MCCULLOCH BLVD S
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86406-8845
Country	:	US
Telephone Number	:	520-609-0969
Fax Number	:

Provider Business Practice Location Address
First Line	:	1716 MCCULLOCH BLVD S
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86406-8845
Country	:	US
Telephone Number	:	520-609-0969
Fax Number	:

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

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	07/08/2007

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