Provider Demographics
NPI:1619103884
Name:KROUT, RYAN M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:M
Last Name:KROUT
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 1:459 WOODSTOCK LN
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4416
Mailing Address - Country:US
Mailing Address - Phone:215-206-7706
Mailing Address - Fax:
Practice Address - Street 1:200 STEVENS DR
Practice Address - Street 2:4TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19113-1522
Practice Address - Country:US
Practice Address - Phone:215-863-5506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP438682183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist