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NPI Code Detail

MEDICARE: ELIZABETH JOHNSON PHARM.D.

MEDICARE: ELIZABETH JOHNSON 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
1183500000XPharmacist118251MN

General Provider Information

NPI Number : 1871579805
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH JOHNSON PHARM.D.
Provider Business Mailing Address
First Line : 2040 HACKBERRY LN
Second Line :
City : SHAKOPEE
State : MN
Zip : 55379-4622
Country : US
Telephone Number : 651-235-5244
Fax Number :
Provider Business Practice Location Address
First Line : 8611 W POINT DOUGLAS RD S
Second Line :
City : COTTAGE GROVE
State : MN
Zip : 55016-4005
Country : US
Telephone Number : 651-241-0420
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2005
Last Update Date : 05/18/2021

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