Healthcare Provider Details

I. General information

NPI: 1578294229
Provider Name (Legal Business Name): ERIN SALO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2022
Last Update Date: 06/23/2022
Certification Date: 06/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W 1ST ST
PAYNESVILLE MN
56362-1445
US

IV. Provider business mailing address

21687 FOREST HILL RD
RICHMOND MN
56368-8160
US

V. Phone/Fax

Practice location:
  • Phone: 320-243-7772
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number125595
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: