Healthcare Provider Details

I. General information

NPI: 1609151687
Provider Name (Legal Business Name): AARON BRUMMER PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2011
Last Update Date: 10/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 2ND AVE N
SAUK RAPIDS MN
56379-1605
US

IV. Provider business mailing address

115 2ND AVE N
SAUK RAPIDS MN
56379-1605
US

V. Phone/Fax

Practice location:
  • Phone: 320-253-6601
  • Fax: 320-253-7858
Mailing address:
  • Phone: 320-253-6601
  • Fax: 320-253-7858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number120055
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: