Provider Demographics
NPI:1386822773
Name:JURENKA, DAVID LEE (PHARMD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:LEE
Last Name:JURENKA
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 1:125 ENGBERG LANE
Mailing Address - Street 2:
Mailing Address - City:BELGRADE
Mailing Address - State:MT
Mailing Address - Zip Code:59714
Mailing Address - Country:US
Mailing Address - Phone:406-240-4577
Mailing Address - Fax:
Practice Address - Street 1:125 ENGBERG LN
Practice Address - Street 2:
Practice Address - City:BELGRADE
Practice Address - State:MT
Practice Address - Zip Code:59714-9130
Practice Address - Country:US
Practice Address - Phone:406-240-4577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT5366183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist