Provider Demographics
NPI:1083914188
Name:RAUTENBACH, LOUIS FREDERICK (RPH)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:FREDERICK
Last Name:RAUTENBACH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20901 N PIMA RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-9193
Mailing Address - Country:US
Mailing Address - Phone:480-585-3026
Mailing Address - Fax:480-585-4581
Practice Address - Street 1:20901 N PIMA RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-9193
Practice Address - Country:US
Practice Address - Phone:480-585-3026
Practice Address - Fax:480-585-4581
Is Sole Proprietor?:No
Enumeration Date:2010-10-24
Last Update Date:2010-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS014013183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist