Provider Demographics
NPI:1750499695
Name:PHILBRICK, ANN M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:M
Last Name:PHILBRICK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:420 DELAWARE ST SE
Mailing Address - Street 2:MMC 387, C-205 MAYO
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455-0341
Mailing Address - Country:US
Mailing Address - Phone:612-625-6843
Mailing Address - Fax:612-626-4613
Practice Address - Street 1:420 DELAWARE ST SE
Practice Address - Street 2:MMC 387, C-205 MAYO
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0341
Practice Address - Country:US
Practice Address - Phone:612-625-6843
Practice Address - Fax:612-626-4613
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20357183500000X
NE12510183500000X
MN119384183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist