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General NPI Number Information
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NPI Number | 1437297207
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Entity Type | Organization
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Legal Business Name | NORTH MEMORIAL MEDICAL CENTER PHARMACY
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 12/09/2024
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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 | 763-520-5639
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Fax | 763-520-4926
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Provider Business Mailing 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 | 763-520-5639
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Fax | 763-520-4926
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Authorized Official
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Title or Position | INTERIM CFO
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Name | STEPHANIE R GALE
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Credential |
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Telephone | 763-581-4635
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 200751-9
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License Number State | MN
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