Dirk Killelea, PHARMD

Individual provider Active NPI Ambulatory Care Pharmacist · Saint Paul, MN

NPI 1922472653 · NPPES record last updated Nov 18, 2015

Key facts

NPI
1922472653
Entity type
Individual (NPI type 1)
Primary specialty
Ambulatory Care Pharmacist 1835P2201X
License
121577 (MN)
Practice address
153 Cesar Chavez St
Saint Paul, MN 55107-2226
Phone
(651) 389-2415
Fax
(651) 602-7502
NPI assigned
Nov 18, 2015
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
121577MNMDAmbulatory Care Pharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Pharmacist 1835P2201X 121577 MN Yes

Addresses

Primary practice location

153 Cesar Chavez St
Saint Paul, MN 55107-2226

Mailing address

153 Cesar Chavez St
Saint Paul, MN 55107-2226
Phone (651) 389-2415

Other providers in Saint Paul, MN

All providers in Saint Paul, MN · Ambulatory Care Pharmacist in Minnesota

Sources for this page

Verify at the official NPI Registry.