Provider Demographics
NPI:1083053144
Name:OLANDER, JAMES D (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:OLANDER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 MICHIGAN AVE W
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:MN
Mailing Address - Zip Code:56484-2274
Mailing Address - Country:US
Mailing Address - Phone:218-547-4734
Mailing Address - Fax:218-547-4523
Practice Address - Street 1:110 MICHIGAN AVE W
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:MN
Practice Address - Zip Code:56484-2274
Practice Address - Country:US
Practice Address - Phone:218-547-4734
Practice Address - Fax:218-547-4523
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-21
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNMN113374183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist