Provider Demographics
NPI:1386631737
Name:FORSELL, LINNEA RUTH (RPH)
Entity Type:Individual
Prefix:
First Name:LINNEA
Middle Name:RUTH
Last Name:FORSELL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 BAYARD AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-1434
Mailing Address - Country:US
Mailing Address - Phone:651-698-1568
Mailing Address - Fax:
Practice Address - Street 1:1106 7TH ST W
Practice Address - Street 2:WEST SEVENTH PHARMACY
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-3829
Practice Address - Country:US
Practice Address - Phone:651-228-1493
Practice Address - Fax:651-228-1968
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN112790-8183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist