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General NPI Number Information
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NPI Number | 1215224514
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Entity Type | Individual
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Provider Name | LORI PATRICIA BORCHARDT RPH
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Gender | Female
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Dates
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Enumeration Date | 07/07/2011
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Last Update Date | 06/10/2014
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Provider Practice Location Address
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Address Line | 550 OSBORNE RD NE
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City | FRIDLEY
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State | MN
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Zip | 55432-2718
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Country | US
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Telephone | 763-236-4111
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Fax | 763-236-4120
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Provider Business Mailing Address
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Address Line | 550 OSBORNE RD NE
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City | FRIDLEY
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State | MN
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Zip | 55432-2718
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Country | US
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Telephone | 763-236-4111
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Fax | 763-236-4120
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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 | 113585
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License Number State | MN
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