Individual
MENGISTU S KIFLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM. D.
Contact information
Practice address
1851 BUNKER LAKE BLVD NW, ANDOVER, MN 55304-4010
(763) 354-5720
Mailing address
1230 SILVERWOOD CT, WOODBURY, MN 55125-9151
(612) 817-1198
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
121462
MN
Other
Enumeration date
12/20/2020
Last updated
12/20/2020
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