Provider Demographics
NPI:1992898738
Name:KRELITZ, BARRY M (RPH)
Entity type:Individual
Prefix:MR
First Name:BARRY
Middle Name:M
Last Name:KRELITZ
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:PO BOX 5003
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-1003
Mailing Address - Country:US
Mailing Address - Phone:612-827-2210
Mailing Address - Fax:612-824-9025
Practice Address - Street 1:3137 HENNEPIN AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2601
Practice Address - Country:US
Practice Address - Phone:612-827-2210
Practice Address - Fax:612-824-9025
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN110523-4183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist