MEDICARE: RIHAB SHOSHAN

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
1	183500000X	Pharmacist	119132	MN

General Provider Information

NPI Number	:	1568880078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RIHAB SHOSHAN

Provider Business Mailing Address
First Line	:	1858 EVERGREEN DRAW
Second Line	:
City	:	WOODBURY
State	:	MN
Zip	:	55125-2306
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 SIGNAL HILLS CTR
Second Line	:
City	:	WEST SAINT PAUL
State	:	MN
Zip	:	55118-2309
Country	:	US
Telephone Number	:	651-457-3355
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2014
Last Update Date	:	04/01/2014

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Directions to “ RIHAB SHOSHAN ” Practice Location

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