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General NPI Number Information
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NPI Number | 1215665922
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Entity Type | Individual
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Provider Name | JOSHUA MICHAEL MAGNUSON RPH, PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/10/2022
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Last Update Date | 08/10/2022
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Provider Practice Location Address
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Address Line | 12195 SINGLETREE LN
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City | EDEN PRAIRIE
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State | MN
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Zip | 55344-4214
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Country | US
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Telephone | 925-829-9030
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Fax |
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Provider Business Mailing Address
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Address Line | 10005 GREENBRIER RD APT 215
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City | MINNETONKA
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State | MN
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Zip | 55305-3415
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Country | US
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Telephone | 651-342-3404
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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 | 125691
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License Number State | MN
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