Provider Demographics
NPI:1700126364
Name:KROLIK, RALPH ELLIOTT (PHARMACIST MD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:ELLIOTT
Last Name:KROLIK
Suffix:
Gender:M
Credentials:PHARMACIST MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9421 W SADDLEHORN RD
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-1312
Mailing Address - Country:US
Mailing Address - Phone:623-251-0975
Mailing Address - Fax:623-878-5941
Practice Address - Street 1:9421 W SADDLEHORN RD
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-1312
Practice Address - Country:US
Practice Address - Phone:623-251-0975
Practice Address - Fax:623-878-5941
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-19
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4936183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist