Provider Demographics
NPI:1205210135
Name:KOLANDER, ADAM ROBERT (RPH)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:ROBERT
Last Name:KOLANDER
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 1:1214 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:BENSON
Mailing Address - State:MN
Mailing Address - Zip Code:56215-1243
Mailing Address - Country:US
Mailing Address - Phone:320-842-3221
Mailing Address - Fax:320-843-9974
Practice Address - Street 1:1214 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:BENSON
Practice Address - State:MN
Practice Address - Zip Code:56215-1243
Practice Address - Country:US
Practice Address - Phone:320-842-3221
Practice Address - Fax:320-843-9974
Is Sole Proprietor?:No
Enumeration Date:2015-07-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN121426183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist