Provider Demographics
NPI:1174793103
Name:KRATZ, GREGORY R (PHARMD)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:R
Last Name:KRATZ
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 1:970 RITTENHOUSE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-2265
Mailing Address - Country:US
Mailing Address - Phone:800-551-0450
Mailing Address - Fax:877-431-1931
Practice Address - Street 1:970 RITTENHOUSE RD STE 200
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:PA
Practice Address - Zip Code:19403-2265
Practice Address - Country:US
Practice Address - Phone:800-551-0450
Practice Address - Fax:877-431-1931
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP044680L183500000X, 1835P0018X
TX581291835P0018X
MD226011835P0018X
MST-120231835P0018X
TN341711835P0018X
KY0148861835P0018X
LA0190601835P0018X
OR00121451835P0018X
ARPD112401835P0018X
NE132981835P0018X
AZS0175511835P0018X
VA2022092681835P0018X
PARPI0062821835P0018X
WVRP00100611835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist