Individual
SAMUEL KOOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
2312 BEMIDJI AVE N, BEMIDJI, MN 56601-2318
(218) 751-1626
Mailing address
2312 BEMIDJI AVE N, BEMIDJI, MN 56601-2318
(218) 751-1626
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
124485
MN
183500000X
Pharmacist
6720
SD
Other
Enumeration date
03/29/2020
Last updated
03/29/2020
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