Provider Demographics
NPI:1134303340
Name:KALENZE, ROSEMARY J (PHARMD)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:J
Last Name:KALENZE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ROSEMARY
Other - Middle Name:J
Other - Last Name:SHELDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1200 S COLUMBIA RD
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-4036
Mailing Address - Country:US
Mailing Address - Phone:701-780-9444
Mailing Address - Fax:701-780-3441
Practice Address - Street 1:1200 S COLUMBIA RD
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-4036
Practice Address - Country:US
Practice Address - Phone:701-780-9444
Practice Address - Fax:701-780-3441
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-24
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024578183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02897450Medicaid