Provider Demographics
NPI:1841572617
Name:KRUEGER, DON (RPH)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:
Last Name:KRUEGER
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 1:391 FREMONT RD
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19362-9120
Mailing Address - Country:US
Mailing Address - Phone:610-998-9873
Mailing Address - Fax:
Practice Address - Street 1:391 FREMONT RD
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:PA
Practice Address - Zip Code:19362-9120
Practice Address - Country:US
Practice Address - Phone:610-998-9873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0002341183500000X
MD16293183500000X
NMRP00004294183500000X
OKR-9634183500000X
PARP37502183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist