Healthcare Provider Details

I. General information

NPI: 1619962818
Provider Name (Legal Business Name): CONSULTANT PHARMACISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23203 BIRCHWOOD ESTATES RD
FERGUS FALLS MN
56537-4516
US

IV. Provider business mailing address

PO BOX 441
FERGUS FALLS MN
56538-0441
US

V. Phone/Fax

Practice location:
  • Phone: 218-736-8157
  • Fax:
Mailing address:
  • Phone: 218-736-8157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1119712
License Number StateMN

VIII. Authorized Official

Name: DR. TODD A JOHNSON
Title or Position: CEO
Credential: PHARM.D.
Phone: 218-736-8157