Provider Demographics
NPI:1477138758
Name:FRISCH, ALLAN STEWART (RPH)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:STEWART
Last Name:FRISCH
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 1:2950 DEAN PKWY APT 1603
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55416-4377
Mailing Address - Country:US
Mailing Address - Phone:612-251-3672
Mailing Address - Fax:
Practice Address - Street 1:9451 DUNKIRK LN N
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55311-5447
Practice Address - Country:US
Practice Address - Phone:763-420-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN111467183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist