Provider Demographics
NPI:1356939631
Name:KRUSE, JAMES (PHARMD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:KRUSE
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 1:4880 LAKELAND DR STE F
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36619-1122
Mailing Address - Country:US
Mailing Address - Phone:251-661-0066
Mailing Address - Fax:251-661-0063
Practice Address - Street 1:4880 LAKELAND DR STE F
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36619-1122
Practice Address - Country:US
Practice Address - Phone:251-661-0066
Practice Address - Fax:251-661-0063
Is Sole Proprietor?:No
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15312183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist