1922655927 NPI number — JAVYN CLARE KRENZEL PHARM. D.; RPH

Table of content: JAVYN CLARE KRENZEL PHARM. D.; RPH (NPI 1922655927)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922655927 NPI number — JAVYN CLARE KRENZEL PHARM. D.; RPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KRENZEL
Provider First Name:
JAVYN
Provider Middle Name:
CLARE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARM. D.; RPH
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922655927
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/23/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 NW 25TH
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOPEKA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66618
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-357-2664
Provider Business Mailing Address Fax Number:
785-357-2668

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 NW 25TH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOPEKA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66618
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-357-2664
Provider Business Practice Location Address Fax Number:
785-357-2668
Provider Enumeration Date:
08/23/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  1-109418 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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