Provider Demographics
NPI:1417920182
Name:KRAUSE, JEFFREY AARON (RPH)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:AARON
Last Name:KRAUSE
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 1:3760 CORNERSTONE LN
Mailing Address - Street 2:
Mailing Address - City:DUNCAN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:43734-9700
Mailing Address - Country:US
Mailing Address - Phone:740-674-4390
Mailing Address - Fax:
Practice Address - Street 1:105 N KENNEBEC AVE
Practice Address - Street 2:
Practice Address - City:MC CONNELSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43756-1254
Practice Address - Country:US
Practice Address - Phone:740-962-2552
Practice Address - Fax:740-962-2730
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-23344183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist