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NPI Code Detail

MEDICARE: CASSANDRA LEWIS PHARM.D.

MEDICARE: CASSANDRA LEWIS PHARM.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist123374MN

General Provider Information

NPI Number : 1053880666
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSANDRA LEWIS PHARM.D.
Provider Business Mailing Address
First Line : 3237 DAKOTA AVE S
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55416-2037
Country : US
Telephone Number : 920-579-0765
Fax Number :
Provider Business Practice Location Address
First Line : 3620 TEXAS AVE S
Second Line :
City : ST LOUIS PARK
State : MN
Zip : 55426-4057
Country : US
Telephone Number : 952-933-3177
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2018
Last Update Date : 11/13/2018

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