Healthcare Provider Details

I. General information

NPI: 1386942696
Provider Name (Legal Business Name): ANN MARIE BRIGINO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2011
Last Update Date: 03/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 PARK AVE PHARMACY, MAIL CODE RL
MINNEAPOLIS MN
55415-1623
US

IV. Provider business mailing address

701 PARK AVE PHARMACY, MAIL CODE RL
MINNEAPOLIS MN
55415-1623
US

V. Phone/Fax

Practice location:
  • Phone: 612-873-7462
  • Fax:
Mailing address:
  • Phone: 612-873-7462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number118970
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: