Provider Demographics
NPI:1841317658
Name:RAUCH, CARL ARTHUR (RPH)
Entity type:Individual
Prefix:MR
First Name:CARL
Middle Name:ARTHUR
Last Name:RAUCH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1536 EGG HARBOR RD
Mailing Address - Street 2:
Mailing Address - City:STURGEON BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54235-1257
Mailing Address - Country:US
Mailing Address - Phone:920-746-0412
Mailing Address - Fax:920-746-9298
Practice Address - Street 1:1536 EGG HARBOR RD
Practice Address - Street 2:
Practice Address - City:STURGEON BAY
Practice Address - State:WI
Practice Address - Zip Code:54235-1257
Practice Address - Country:US
Practice Address - Phone:920-746-0412
Practice Address - Fax:920-746-9298
Is Sole Proprietor?:No
Enumeration Date:2007-03-25
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL51-33659183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist