Marvin Leroy Dyrstad in Red Wing - Pharmacist
Marvin Leroy Dyrstad - NPI 1215937099
Marvin Leroy Dyrstad is a Pharmacist in Red Wing, Minnesota. Marvin Leroy Dyrstad practices all healthcare services and medical treatments related to Pharmacist. The NPI Number for Marvin Leroy Dyrstad is 1215937099. The last update date is 2007-07-08.
Marvin Leroy Dyrstad's current location address is 910 W 6th St, Red Wing, Minnesota. You can contact this provider via phone number 6513886883 and fax number 6513886796. The mailing address for Marvin Leroy Dyrstad is 910 W 6th St, Red Wing, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Marvin Leroy Dyrstad |
|---|---|
| Address | 910 W 6th St, Red Wing, Minnesota |
| Phone Number | 6513886883 |
| Fax Number | 6513886796 |
| Sole Proprietor | X |
| Credentials | RPH |
NPI Number Detail
| NPI Number | 1215937099 |
|---|---|
| Provider Enumeration Date | 2005-07-22 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 910 W 6th St |
|---|---|
| City | Red Wing |
| State | Minnesota (MN) |
| Post Code | 550662432 |
| Phone Number | 6513886883 |
| Fax Number | 6513886796 |
Provider's Primary Taxonomy Detail
| Speciality | Pharmacist |
|---|---|
| Taxonomy | 183500000X |
| Licence No | 110761-4 |
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Definition: An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or m |
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Post Comment/ Review Below
What is the unique identifier code issued to Marvin Leroy Dyrstad by the Centers for Medicare & Medicaid Services (CMS)?
The Marvin Leroy Dyrstad has been assigned the NPI (National Provider Identifier) 1215937099. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you provide the complete physical address where Marvin Leroy Dyrstad is located?
The Marvin Leroy Dyrstad is situated at the following address: 910 W 6Th St, Red Wing, MN, 550662432.
What is Marvin Leroy Dyrstad's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Marvin Leroy Dyrstad's specialized field of practice is Pharmacist, and the corresponding taxonomy code that categorizes this area of specialization is 183500000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1215937099 to Marvin Leroy Dyrstad?
The Marvin Leroy Dyrstad received its 1215937099 assignment from the Centers for Medicare & Medicaid Services on 2005-07-22.
As of what date were the details related to Marvin Leroy Dyrstad most recently updated or revised?
The information pertaining to Marvin Leroy Dyrstad, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.