Alan Richard Brosseau, R.PH.
Individual provider Active NPI Pharmacist · New Hope, MN
NPI 1487765285 · NPPES record last updated Jul 11, 2007
Key facts
- NPI
- 1487765285
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 115416 (MN)
- Practice address
- 8000 Bass Lake Rd # 200
New Hope, MN 55428-3118 - Phone
- (763) 531-5005
- Fax
- (763) 531-5061
- NPI assigned
- Aug 31, 2006
- 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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115416 | MN | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 115416 | MN | Yes |
Addresses
Primary practice location
8000 Bass Lake Rd # 200
New Hope, MN 55428-3118
Mailing address
8000 Bass Lake Rd # 200
New Hope, MN 55428-3118
Phone (763) 531-5005
Other providers in New Hope, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2007. 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.