Provider Demographics
NPI:1376838276
Name:STRONCEK, ROBERT FRANCIS
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:FRANCIS
Last Name:STRONCEK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6100 SHINGLE CREEK PKWY
Mailing Address - Street 2:T-0240
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-2110
Mailing Address - Country:US
Mailing Address - Phone:763-566-0143
Mailing Address - Fax:763-566-0143
Practice Address - Street 1:6100 SHINGLE CREEK PKWY
Practice Address - Street 2:T-0240
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55430-2110
Practice Address - Country:US
Practice Address - Phone:763-566-0143
Practice Address - Fax:763-566-0143
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN113519183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist