Provider Demographics
NPI:1861732430
Name:KRAUS, LARRY W (RPH)
Entity type:Individual
Prefix:
First Name:LARRY
Middle Name:W
Last Name:KRAUS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7150 NATURAL BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63121-5151
Mailing Address - Country:US
Mailing Address - Phone:314-381-8600
Mailing Address - Fax:
Practice Address - Street 1:7150 NATURAL BRIDGE RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63121-5151
Practice Address - Country:US
Practice Address - Phone:314-381-8600
Practice Address - Fax:314-381-6844
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-19
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO030022183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO030022OtherMISSOURI STATE REGISTERED PHARMACIST PERMITT