Healthcare Provider Details

I. General information

NPI: 1962507806
Provider Name (Legal Business Name): JAYSON A YAPEL PHARMACIST IN CHARGE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 04/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1502 LONDON RD SUITE 101
DULUTH MN
55812-1788
US

IV. Provider business mailing address

1502 LONDON RD SUITE 101
DULUTH MN
55812-1788
US

V. Phone/Fax

Practice location:
  • Phone: 218-576-0150
  • Fax:
Mailing address:
  • Phone: 218-576-0150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number115667-8
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: