Provider Demographics
NPI:1801322342
Name:KREUTER, ANGELA (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:KREUTER
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-9551
Mailing Address - Country:US
Mailing Address - Phone:740-964-5105
Mailing Address - Fax:740-964-5107
Practice Address - Street 1:350 E BROAD ST
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062-9551
Practice Address - Country:US
Practice Address - Phone:740-964-5105
Practice Address - Fax:740-964-5107
Is Sole Proprietor?:No
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03228197183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist