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NPI Code Detail

MEDICARE: RONDA MARIE CHAKOLIS PHARMD

MEDICARE: RONDA MARIE CHAKOLIS PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist119824MN

General Provider Information

NPI Number : 1003436262
Entity Type Code : Individual
Provider Name (Legal Business Name) : RONDA MARIE CHAKOLIS PHARMD
Provider Business Mailing Address
First Line : 3934 WASHBURN AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55412-1825
Country : US
Telephone Number : 612-388-4142
Fax Number :
Provider Business Practice Location Address
First Line : 4656 EXCELSIOR BLVD
Second Line :
City : SAINT LOUIS PARK
State : MN
Zip : 55416-4938
Country : US
Telephone Number : 952-929-0140
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2020
Last Update Date : 04/17/2020

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Directions to “ RONDA MARIE CHAKOLIS PHARMD” Practice Location

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