Provider Demographics
NPI:1528470887
Name:KRUP, LAUREN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:KRUP
Suffix:
Gender:F
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:PO BOX 1351
Mailing Address - Street 2:
Mailing Address - City:PISMO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93448-1351
Mailing Address - Country:US
Mailing Address - Phone:805-547-7887
Mailing Address - Fax:805-547-7560
Practice Address - Street 1:CALIFORNIA MENS COLONY
Practice Address - Street 2:HIGHWAY 1
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93409-0001
Practice Address - Country:US
Practice Address - Phone:805-547-7887
Practice Address - Fax:805-547-7560
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-21
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA311391835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist