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NPI Code Detail

MEDICARE: MR. WILLIAM ANDREW WIMMER RPH

MEDICARE: MR. WILLIAM ANDREW WIMMER RPH
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
1183500000XPharmacist114787-0MN

General Provider Information

NPI Number : 1285638221
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WILLIAM ANDREW WIMMER RPH
Provider Business Mailing Address
First Line : 8900 167TH N NW
Second Line :
City : RAMSEY
State : MN
Zip : 55303
Country : US
Telephone Number : 763-441-0764
Fax Number : 763-712-6429
Provider Business Practice Location Address
First Line : 530 3RD ST NW
Second Line :
City : ELK RIVER
State : MN
Zip : 55330-1445
Country : US
Telephone Number : 763-441-0764
Fax Number : 763-712-6429
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2005
Last Update Date : 07/08/2007

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Directions to “ MR. WILLIAM ANDREW WIMMER RPH” Practice Location

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