Provider Demographics
NPI:1851997480
Name:MAJERLE, JOHN RUDOLPH (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:RUDOLPH
Last Name:MAJERLE
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 8TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-2806
Mailing Address - Country:US
Mailing Address - Phone:218-828-0440
Mailing Address - Fax:
Practice Address - Street 1:417 8TH AVE NE
Practice Address - Street 2:
Practice Address - City:BRAINERD
Practice Address - State:MN
Practice Address - Zip Code:56401-2806
Practice Address - Country:US
Practice Address - Phone:218-828-0440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN115949183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist