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General NPI Number Information
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NPI Number | 1013729482
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Entity Type | Organization
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Legal Business Name | MINNESOTA MEDICATION REPOSITORY PROGRAM
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Dates
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Enumeration Date | 01/23/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 2112 BROADWAY ST NE STE 230
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City | MINNEAPOLIS
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State | MN
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Zip | 55413-3102
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Country | US
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Telephone | 612-584-4647
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Fax | 866-254-9105
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Provider Business Mailing Address
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Address Line | 2112 BROADWAY ST NE STE 230
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City | MINNEAPOLIS
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State | MN
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Zip | 55413-3102
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Country | US
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Telephone | 612-584-4647
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Fax | 866-254-9105
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Authorized Official
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Title or Position | DIRECTOR & PHARMACIST IN CHARGE
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Name | DR. RACHEL ROCKWELL
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Credential | PHARMD, RPH, MPH
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Telephone | 612-584-4647
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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