Dana Forsberg
Individual provider Active NPI Pharmacist · Wadena, MN
NPI 1699377697 · NPPES record last updated Nov 13, 2020
Key facts
- NPI
- 1699377697
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 115434 (MN)
- Practice address
- 100 Juniper Ave
Wadena, MN 56482-1041 - Phone
- (218) 631-1723
- NPI assigned
- Nov 13, 2020
- 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 |
|---|---|---|---|
| 115434 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past |
Accepting new patients | |
| Walmart Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 115434 | MN | Yes |
Addresses
Primary practice location
100 Juniper Ave
Wadena, MN 56482-1041
Mailing address
PO Box 1225
Walker, MN 56484-1225
Phone (218) 547-2053
Other providers in Wadena, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 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.