Provider Demographics
NPI:1629698857
Name:ENGLEKA, RICHARD (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:ENGLEKA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18303 66TH PL N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55311-4513
Mailing Address - Country:US
Mailing Address - Phone:651-414-3308
Mailing Address - Fax:
Practice Address - Street 1:18303 66TH PL N
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55311-4513
Practice Address - Country:US
Practice Address - Phone:651-414-3308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-17
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN118752183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist