David Clyne, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

1163218 Issued in MN

Practice address

21495 141St Ave N
Rogers, MN 55374-4583

Phone

(763) 428-5802

Fax

(763) 428-3057

NPI assigned

Oct 19, 2011

Last updated

Oct 19, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Walgreen Co

  dba Walgreens #07812

  • Pharmacy
  • Rogers, MN
  • NPI 1932114162
  NPD (past)
• Walgreen Co

  dba Walgreens #21605

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1770868838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21495 141ST AVE N",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553744583",
            "telephone_number": "763-428-5802",
            "fax_number": "763-428-3057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21495 141ST AVE N",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553744583",
            "telephone_number": "763-428-5802",
            "fax_number": "763-428-3057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLYNE",
        "first_name": "DAVID",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-19",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "1163218",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051-032107",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carelink Home Health Care LLC
• Aeja Marie Carlson
• Jennifer L Carlson
• Carrie Anns Homecare Houses LLC
• Emily D Christianson
• Leah Marie Colby, O.D.
• Paul Allen Colligan, DNP, CRNA, APRN, PHN
• Marion Conwell
• Rachel Annastasia Coulter
• Abigail Dawn Covington

• Pharmacist in Rogers, MN
• Providers in Rogers, MN by specialty
• Pharmacist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.