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General NPI Number Information
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NPI Number | 1982692885
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Entity Type | Individual
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Provider Name | SHANNON MARIE GOBLIRSCH PHARM.D.,R.PH.
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Gender | Female
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Dates
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Enumeration Date | 10/13/2005
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Last Update Date | 02/07/2017
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Provider Practice Location Address
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Address Line | 39648 RESERVATION HIGHWAY 3
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City | MORTON
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State | MN
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Zip | 56270-0299
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Country | US
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Telephone | 507-697-8950
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Fax | 507-697-8954
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Provider Business Mailing Address
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Address Line | PO BOX 299 39648 RESERVATION HIGHWAY 3
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City | MORTON
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State | MN
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Zip | 56270-0299
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Country | US
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Telephone | 507-697-8950
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Fax | 507-697-8954
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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 | 117045-0
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License Number State | MN
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