Provider Demographics
NPI:1508856527
Name:KOSKI, DANIEL WILLIAM (RPH)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:WILLIAM
Last Name:KOSKI
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 1:750 MAIN ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MENDOTA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55118-3764
Mailing Address - Country:US
Mailing Address - Phone:651-455-6873
Mailing Address - Fax:651-451-7997
Practice Address - Street 1:750 MAIN ST
Practice Address - Street 2:SUITE 103
Practice Address - City:MENDOTA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55118-3764
Practice Address - Country:US
Practice Address - Phone:651-455-6873
Practice Address - Fax:651-451-7997
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1136601183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist