Gallentine, Stacie Marie
Gallentine, Stacie Marie is an sole proprietor health care provider with primary practice located at 9655 Colorado Ln N , Brooklyn Park MN 55445. She recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as her primary health care specialty. Gallentine, Stacie Marie can be contacted via phone (763) 315-0737.Contact Information
Primary practice address
9655 Colorado Ln N
Brooklyn Park MN 55445
Phone: (763) 315-0737
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | 118193 | Minnesota |
Profile Details
| NPI number | 1508063249 |
|---|---|
| LBN Legal business name | Gallentine, Stacie Marie |
| Credentials | PHARM D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 27th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508063249 | NPPES |
| Minnesota | Other | 118193 | PHARMACIST LICENSE |
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