Provider Demographics
NPI:1689123259
Name:KRUMM, RODNEY JOSEPH JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:JOSEPH
Last Name:KRUMM
Suffix:JR
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 1:2045 HIGHWAY 59
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-1909
Mailing Address - Country:US
Mailing Address - Phone:985-626-7926
Mailing Address - Fax:985-626-7919
Practice Address - Street 1:2045 HIGHWAY 59
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448-1909
Practice Address - Country:US
Practice Address - Phone:985-626-7926
Practice Address - Fax:985-626-7919
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST016050183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist