Healthcare Provider Details

I. General information

NPI: 1447175336
Provider Name (Legal Business Name): CAROLYN BAUER
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1216 2ND ST SW
ROCHESTER MN
55902-1906
US

IV. Provider business mailing address

1216 2ND ST SW
ROCHESTER MN
55902-1906
US

V. Phone/Fax

Practice location:
  • Phone: 507-255-5123
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number122527
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: