Healthcare Provider Details

I. General information

NPI: 1467370072
Provider Name (Legal Business Name): ADAM CLOSMORE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1285 NORTHLAND DR
MENDOTA HEIGHTS MN
55120-1374
US

IV. Provider business mailing address

220 VIRGINIA AVE
INDIANAPOLIS IN
46204-3709
US

V. Phone/Fax

Practice location:
  • Phone: 877-606-3338
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number125166
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: