MEDICARE: AMY MICHELLE BJORK RPH

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	116660-0	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	116660-0	OTHER	MN	MINNESOTA BOARD OF PHARMACY LICENSE

General Provider Information

NPI Number	:	1518247196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY MICHELLE BJORK RPH

Provider Business Mailing Address
First Line	:	550 VANDALIA ST
Second Line	:	STE. 175
City	:	SAINT PAUL
State	:	MN
Zip	:	55114-1833
Country	:	US
Telephone Number	:	651-313-6733
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 VANDALIA ST
Second Line	:	STE. 175
City	:	SAINT PAUL
State	:	MN
Zip	:	55114-1833
Country	:	US
Telephone Number	:	651-313-6733
Fax Number	:

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

Provider Enumeration Date	:	08/26/2011
Last Update Date	:	02/15/2017

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