Provider Demographics
NPI:1194119529
Name:CROLIUS, DAVID (PHARM D, RPH)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:CROLIUS
Suffix:
Gender:M
Credentials:PHARM D, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7446 S LOUISE AVE
Mailing Address - Street 2:APT 205
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-5977
Mailing Address - Country:US
Mailing Address - Phone:605-521-8124
Mailing Address - Fax:
Practice Address - Street 1:2503 E 54TH ST N
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-5563
Practice Address - Country:US
Practice Address - Phone:605-978-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR5906183500000X
NDRPH4722183500000X
KY017476183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist