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NPI Code Detail

MEDICARE: MS. LIATTE KRUEGER PHARMD

MEDICARE: MS. LIATTE KRUEGER PHARMD
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
1183500000XPharmacistRI31305NJ

General Provider Information

NPI Number : 1558483719
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LIATTE KRUEGER PHARMD
Provider Business Mailing Address
First Line : 836 41ST ST NW
Second Line : APT B303
City : ROCHESTER
State : MN
Zip : 55901-4247
Country : US
Telephone Number : 908-499-5998
Fax Number :
Provider Business Practice Location Address
First Line : 2110 E CENTER ST
Second Line :
City : ROCHESTER
State : MN
Zip : 55904-4754
Country : US
Telephone Number : 507-287-0674
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2007
Last Update Date : 07/08/2007

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