Provider Demographics
NPI:1174276166
Name:IRWIN, CHERYL (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:IRWIN
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 NICOLLET MALL
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-2530
Mailing Address - Country:US
Mailing Address - Phone:612-296-0540
Mailing Address - Fax:
Practice Address - Street 1:13201 RIDGEDALE DR
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1809
Practice Address - Country:US
Practice Address - Phone:952-542-8266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN113498183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty