Individual provider · Type 1 NPI

William J. Supalla, RPH

Pharmacist · Fairmont, MN

NPI number 1760520373 Active

Practice location

322 S State St, Five Lakes Centre
Fairmont, MN 56031-4139

Call (507) 238-2797 Map

Fax (507) 238-4701

Mailing address

3819 Cedar Creek Ct
Fairmont, MN 56031-2432

Specialties and licenses

TaxonomyCodeLicense
Pharmacist Primary 183500000X111504-6 (MN)

Pharmacist: An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage…

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About NPI 1760520373

William J. Supalla, RPH's National Provider Identifier is 1760520373, issued on Feb 3, 2007. The primary taxonomy on file is Pharmacist (183500000X), and the practice location is in Fairmont, MN. The record was last updated on Jul 8, 2007.