MEDICARE: DR. ALAN WEISENBERGER 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	1182448	MN

General Provider Information

NPI Number	:	1972632545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN WEISENBERGER PHARM.D.

Provider Business Mailing Address
First Line	:	5801 RIDGEWOOD RD STE 4
Second Line	:
City	:	SAINT CLOUD
State	:	MN
Zip	:	56303-1303
Country	:	US
Telephone Number	:	320-251-5505
Fax Number	:	320-203-1095

Provider Business Practice Location Address
First Line	:	5801 RIDGEWOOD RD STE 4
Second Line	:
City	:	SAINT CLOUD
State	:	MN
Zip	:	56303-1303
Country	:	US
Telephone Number	:	320-251-5505
Fax Number	:	320-203-1095

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

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	06/04/2011

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