Healthcare Provider Details

I. General information

NPI: 1023930898
Provider Name (Legal Business Name): CAMILLE SIMONETTE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E 1ST ST STE 200
DULUTH MN
55805-2297
US

IV. Provider business mailing address

1000 E 1ST ST STE 200
DULUTH MN
55805-2297
US

V. Phone/Fax

Practice location:
  • Phone: 218-491-1893
  • Fax:
Mailing address:
  • Phone: 218-491-1893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number127440
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: