MEDICARE: AFDAHL PHARMACY PLLC

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	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1740137660
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFDAHL PHARMACY PLLC

Provider Business Mailing Address
First Line	:	4110 CENTRAL AVE NE STE 206
Second Line	:
City	:	COLUMBIA HEIGHTS
State	:	MN
Zip	:	55421-2964
Country	:	US
Telephone Number	:	763-762-8983
Fax Number	:	763-207-0801

Provider Business Practice Location Address
First Line	:	4110 CENTRAL AVE NE STE 206
Second Line	:
City	:	COLUMBIA HEIGHTS
State	:	MN
Zip	:	55421-2964
Country	:	US
Telephone Number	:	763-762-8983
Fax Number	:	763-207-0801

Authorized Official
Title or Position	:	PHARMACIST IN CHARGE
Name	:	FAHIMA HASSAN
Credential	:
Telephone Number	:	763-762-8983

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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