Healthcare Provider Details

I. General information

NPI: 1053285296
Provider Name (Legal Business Name): ALYSSA AUGST PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2025
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 CENTRACARE CIR STE 1600
SAINT CLOUD MN
56303-5000
US

IV. Provider business mailing address

5495 NE RIVER RD
SAUK RAPIDS MN
56379-9307
US

V. Phone/Fax

Practice location:
  • Phone: 320-229-4927
  • Fax:
Mailing address:
  • Phone: 320-229-4927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number119662
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: