Provider Demographics
NPI:1922652718
Name:SCHRUERS, DAVID KENTON (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:KENTON
Last Name:SCHRUERS
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 1:4000 DEKALB TECHNOLOGY PKWY STE 320
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30340-2764
Mailing Address - Country:US
Mailing Address - Phone:404-364-7073
Mailing Address - Fax:404-949-5242
Practice Address - Street 1:4000 DEKALB TECHNOLOGY PKWY STE 320
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30340-2764
Practice Address - Country:US
Practice Address - Phone:404-364-7073
Practice Address - Fax:404-949-5242
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH015073183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist