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General NPI Number Information
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NPI Number | 1598642258
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Entity Type | Individual
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Provider Name | JIMMY MORALES PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/16/2025
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Last Update Date | 08/16/2025
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Provider Practice Location Address
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Address Line | 1100 BERGSLIEN ST
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City | BALDWIN
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State | WI
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Zip | 54002-2600
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Country | US
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Telephone | 715-684-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 3881 BENJAMIN DR
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City | WOODBURY
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State | MN
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Zip | 55125-3395
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Country | US
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Telephone | 651-353-7141
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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 | 23165-40
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License Number State | WI
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