Provider Demographics
NPI:1407145113
Name:BJORKLUND, DONALD CARL
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:CARL
Last Name:BJORKLUND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 SPRINGFIELD ST
Mailing Address - Street 2:
Mailing Address - City:AGAWAM
Mailing Address - State:MA
Mailing Address - Zip Code:01001-1521
Mailing Address - Country:US
Mailing Address - Phone:413-786-6060
Mailing Address - Fax:413-789-3368
Practice Address - Street 1:17 SPRINGFIELD ST
Practice Address - Street 2:
Practice Address - City:AGAWAM
Practice Address - State:MA
Practice Address - Zip Code:01001-1521
Practice Address - Country:US
Practice Address - Phone:413-786-6060
Practice Address - Fax:413-789-3368
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16210183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist