Provider Demographics
NPI:1407386733
Name:KURUCZ, KIMBERLY GARRETT (RPH)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:GARRETT
Last Name:KURUCZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4351 COUNTY ROAD 4404
Mailing Address - Street 2:
Mailing Address - City:BANKS
Mailing Address - State:AL
Mailing Address - Zip Code:36005-3052
Mailing Address - Country:US
Mailing Address - Phone:334-243-4040
Mailing Address - Fax:334-566-5739
Practice Address - Street 1:1420 US 231 SOUTH
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:AL
Practice Address - Zip Code:36081
Practice Address - Country:US
Practice Address - Phone:334-566-8009
Practice Address - Fax:334-566-5739
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11810183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist