Kim Rux, RPH

Individual provider Active NPI Pharmacist · Waseca, MN

NPI 1023616646 · NPPES record last updated Oct 15, 2020

Key facts

NPI
1023616646
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
114484 (MN)
Practice address
2103 State St N
Waseca, MN 56093-2605
Phone
(507) 835-8184
NPI assigned
Oct 15, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
114484MNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walmart Inc. Past
since Oct 19, 2020
Accepting new patients
Walmart Inc. Past
since Oct 19, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 114484 MN Yes

Addresses

Primary practice location

2103 State St N
Waseca, MN 56093-2605

Mailing address

1201 8TH St SE
Waseca, MN 56093-3906
Phone (507) 461-0144

Other providers in Waseca, MN

All providers in Waseca, MN · Pharmacist in Minnesota

Sources for this page

Verify at the official NPI Registry.