Healthcare Provider Details

I. General information

NPI: 1023620499
Provider Name (Legal Business Name): QUERYRX
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2020
Last Update Date: 08/18/2020
Certification Date: 08/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5995 OPUS PKWY
MINNETONKA MN
55343-8387
US

IV. Provider business mailing address

5995 OPUS PKWY
MINNETONKA MN
55343-8387
US

V. Phone/Fax

Practice location:
  • Phone: 952-219-4056
  • Fax:
Mailing address:
  • Phone: 952-219-4056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: GABRIEL JOHNSON
Title or Position: PHARMACIST IN CHARGE
Credential: PHARMD.
Phone: 952-219-4071