Healthcare Provider Details

I. General information

NPI: 1528288875
Provider Name (Legal Business Name): REGENTS OF THE UNIVERSITY OF MINNESOTA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2007
Last Update Date: 10/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 CHURCH STREET SE
MINNEAPOLIS MN
55455-0346
US

IV. Provider business mailing address

410 CHURCH STREET SE
MINNEAPOLIS MN
55455-0346
US

V. Phone/Fax

Practice location:
  • Phone: 612-625-8400
  • Fax: 612-625-1434
Mailing address:
  • Phone: 612-625-8400
  • Fax: 612-625-1434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. EDWARD PETER EHLINGER
Title or Position: DIRECTOR
Credential: MD
Phone: 612-625-1612