Provider Demographics
NPI:1619263738
Name:KRAUSE, TIMOTHY J (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:J
Last Name:KRAUSE
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6445 RICHFIELD PKWY
Mailing Address - Street 2:T-2300
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-6400
Mailing Address - Country:US
Mailing Address - Phone:612-252-0474
Mailing Address - Fax:612-252-0484
Practice Address - Street 1:6445 RICHFIELD PKWY
Practice Address - Street 2:T-2300
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-6400
Practice Address - Country:US
Practice Address - Phone:612-252-0474
Practice Address - Fax:612-252-0484
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN118629183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist