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General NPI Number Information
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NPI Number | 1033327671
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Entity Type | Individual
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Provider Name | AMBER MARIE HOUSE PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3300 OAKDALE AVE N
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City | ROBBINSDALE
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State | MN
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Zip | 55422-2926
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Country | US
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Telephone | 763-520-3170
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Fax | 763-520-4926
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Provider Business Mailing Address
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Address Line | 968 139TH AVE NW
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City | ANDOVER
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State | MN
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Zip | 55304-4124
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Country | US
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Telephone | 763-754-1396
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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 | 118602
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License Number State | MN
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