Healthcare Provider Details

I. General information

NPI: 1508454992
Provider Name (Legal Business Name): ABBY LORAY BUELIGEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2021
Last Update Date: 01/02/2021
Certification Date: 01/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 HIGHWAY 10 E
MOORHEAD MN
56560-2516
US

IV. Provider business mailing address

2107 WESTGATE DR
HAWLEY MN
56549-4413
US

V. Phone/Fax

Practice location:
  • Phone: 218-233-2953
  • Fax:
Mailing address:
  • Phone: 612-670-2237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH5794
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number122334
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: