Troy Douglas West
Individual provider Active NPI Pharmacist · Ely, MN
NPI 1104102177 · NPPES record last updated Apr 8, 2022
Key facts
- NPI
- 1104102177
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 115284 (MN)
- Practice address
- 1500 E Sheridan St Ste 100
Ely, MN 55731-1855 - Phone
- (218) 365-1855
- Fax
- (218) 365-2232
- NPI assigned
- Oct 22, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115284 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Duluth Clinic, LTD. | Current |
Accepting new patients | |
| The Duluth Clinic, LTD. | Past |
Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
1500 E Sheridan St
#100
Ely, MN 55731
Phone (218) 365-1855
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 115284 | MN | Yes |
Addresses
Primary practice location
1500 E Sheridan St Ste 100
Ely, MN 55731-1855
Mailing address
1500 E Sheridan St Ste 100
Ely, MN 55731-1855
Phone (218) 365-7957
Other providers in Ely, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.