Provider Demographics
NPI:1932452661
Name:POGATCHNIK, DAVID PETER (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:PETER
Last Name:POGATCHNIK
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 1:42648 COUNTY ROAD 1
Mailing Address - Street 2:
Mailing Address - City:RICE
Mailing Address - State:MN
Mailing Address - Zip Code:56367-7500
Mailing Address - Country:US
Mailing Address - Phone:320-253-7181
Mailing Address - Fax:
Practice Address - Street 1:2251 CONNECTICUT AVE. SOUTH
Practice Address - Street 2:HEALTH PARTNERS CENTRAL MINNESOTA CLINICS (PHARMACY)
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377
Practice Address - Country:US
Practice Address - Phone:320-259-7321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN111805183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist