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NPI Code Detail

MEDICARE: MR. WALTER RONALD KRAUS RPH

MEDICARE:  MR. WALTER RONALD KRAUS  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
1183500000XPharmacist5302024738MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15302024738OTHERMIMICHIGAN PHARMACY LICENSE

General Provider Information

NPI Number : 1851393722
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WALTER RONALD KRAUS RPH
Provider Business Mailing Address
First Line : 6427 APPLE BLOSSOM LN
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-5066
Country : US
Telephone Number : 231-943-4983
Fax Number :
Provider Business Practice Location Address
First Line : 1712 S GARFIELD AVE
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49686-4338
Country : US
Telephone Number : 231-941-8432
Fax Number : 231-941-9152
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 07/08/2007

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Directions to “ MR. WALTER RONALD KRAUS RPH” Practice Location

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