Brandon Mork, PHARMD
Individual provider Active NPI Pharmacist · Winsted, MN
NPI 1316545643 · NPPES record last updated Oct 9, 2020
Key facts
- NPI
- 1316545643
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 124618 (MN)
- Practice address
- 150 Main Ave W
Winsted, MN 55395-7872 - Phone
- (320) 485-2555
- Fax
- (320) 485-4266
- NPI assigned
- Oct 9, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 124618 | MN | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 124618 | MN | Yes |
Addresses
Primary practice location
150 Main Ave W
Winsted, MN 55395-7872
Mailing address
537 Stevens St SW
Watertown, MN 55388-9215
Phone (612) 387-3872
Other providers in Winsted, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2020. 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.