Provider Demographics
NPI:1417382003
Name:WOOD, ANGELA (PHARMD, BCPS)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 OAKDALE AVE N
Mailing Address - Street 2:
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422-2926
Mailing Address - Country:US
Mailing Address - Phone:763-581-6331
Mailing Address - Fax:763-581-6334
Practice Address - Street 1:3300 OAKDALE AVE N
Practice Address - Street 2:
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422
Practice Address - Country:US
Practice Address - Phone:763-581-6331
Practice Address - Fax:763-581-6334
Is Sole Proprietor?:No
Enumeration Date:2013-09-13
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051295134183500000X
MN120161183500000X
WI15571-40183500000X
MO2013029805183500000X
KS1-16039183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist