Caitlin Pederson
Individual provider Active NPI Pharmacist · Glenwood, MN
NPI 1558868554 · NPPES record last updated Apr 7, 2018
Key facts
- NPI
- 1558868554
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 123384 (MN)
- Practice address
- 7 4TH Ave SE
Glenwood, MN 56334-1879 - Phone
- (320) 634-4434
- Fax
- (320) 634-5632
- NPI assigned
- Apr 7, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| 123384 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trumm Drug, Inc. | Past |
Accepting new patients | |
| Trumm Drug, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 123384 | MN | Yes |
Addresses
Primary practice location
7 4TH Ave SE
Glenwood, MN 56334-1879
Mailing address
PO Box 198
Glenwood, MN 56334-0198
Phone (320) 634-4434
Other names
- Caitlin Peterson
Other providers in Glenwood, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 7, 2018. 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.