MEDICARE: DR. DARCY LYNN PAULSEN PHARM.D.

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
1	183500000X	Pharmacist	115758-3	MN

General Provider Information

NPI Number	:	1043377617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARCY LYNN PAULSEN PHARM.D.

Provider Business Mailing Address
First Line	:	11400 275TH ST
Second Line	:
City	:	CHISAGO CITY
State	:	MN
Zip	:	55013-5411
Country	:	US
Telephone Number	:	651-213-0023
Fax Number	:	651-982-7236

Provider Business Practice Location Address
First Line	:	11400 275TH ST
Second Line	:
City	:	CHISAGO CITY
State	:	MN
Zip	:	55013-5411
Country	:	US
Telephone Number	:	651-213-0023
Fax Number	:	651-982-7236

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	07/08/2007

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