Wilma Ann Certain, R.PH.
Individual provider Active NPI Pharmacist · Perham, MN
NPI 1669813796 · NPPES record last updated Jul 17, 2013
Key facts
- NPI
- 1669813796
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 118482 (MN)
- Practice address
- 125 1St Ave S
Perham, MN 56573-1701 - Phone
- (218) 346-4840
- Fax
- (218) 346-4844
- NPI assigned
- Jul 17, 2013
- 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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26015367A | IN | MD | Pharmacist |
| 118482 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| White Drug Enterprises Inc | Past | Accepting new patients | |
| White Drug Enterprises Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 118482 | MN | Yes |
| Pharmacist | 183500000X | 26015367A | IN |
Addresses
Primary practice location
125 1St Ave S
Perham, MN 56573-1701
Mailing address
125 1St Ave S
Perham, MN 56573-1701
Phone (218) 346-4840
Other providers in Perham, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2013. 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.