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General NPI Number Information
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NPI Number | 1962203315
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Entity Type | Individual
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Provider Name | AMELIA OLSON PHARMD
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Gender | Female
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Dates
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Enumeration Date | 03/21/2025
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 24760 HOSPITAL ROAD
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City | RED LAKE
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State | MN
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Zip | 56671
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Country | US
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Telephone | 218-679-3912
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Fax |
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Provider Business Mailing Address
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Address Line | 715 LAKE SHORE DR NE UNIT 113
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City | BEMIDJI
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State | MN
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Zip | 56601-4162
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Country | US
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Telephone | 774-266-4625
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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 | PH1000785
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License Number State | MA
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