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General NPI Number Information
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NPI Number | 1043223779
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Entity Type | Individual
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Provider Name | RYAN D LUNDELL R.PH.
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Gender | Male
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | ST. CLOUD VETERANS AFFAIRS MEDICAL CENTER 4801 8TH STREET NORTH
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City | ST. CLOUD
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State | MN
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Zip | 56303-2099
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Country | US
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Telephone | 320-255-6465
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Fax | 320-255-6360
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Provider Business Mailing Address
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Address Line | 1 MICHAELS COURT
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City | SARTELL
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State | MN
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Zip | 56377-2012
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Country | US
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Telephone |
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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 | 116665-5
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 4721
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License Number State | ND
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Taxonomy #3
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 116665-5
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License Number State | MN
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