Provider Demographics
NPI:1154065910
Name:ESPENHEIN, RUNE (PHARMD)
Entity Type:Individual
Prefix:
First Name:RUNE
Middle Name:
Last Name:ESPENHEIN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3139 WILLOW CREEK RD APT 343
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-6798
Mailing Address - Country:US
Mailing Address - Phone:480-622-6545
Mailing Address - Fax:
Practice Address - Street 1:3139 WILLOW CREEK RD APT 343
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-6798
Practice Address - Country:US
Practice Address - Phone:480-622-6545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-26
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS018062183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist