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General NPI Number Information
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NPI Number | 1013515485
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Entity Type | Individual
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Provider Name | CASSANDRA LE PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/16/2020
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Last Update Date | 10/16/2020
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Provider Practice Location Address
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Address Line | 9165 CAHILL AVE
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City | INVER GROVE HEIGHTS
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State | MN
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Zip | 55076-3542
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Country | US
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Telephone | 651-451-7860
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Fax |
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Provider Business Mailing Address
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Address Line | 4091 WILD GOOSE LN
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City | WHITE BEAR LAKE
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State | MN
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Zip | 55110-7639
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Country | US
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Telephone | 651-503-3591
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 124955
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License Number State | MN
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