Provider Demographics
NPI:1053735787
Name:BELL, LOREN (RPH)
Entity type:Individual
Prefix:MR
First Name:LOREN
Middle Name:
Last Name:BELL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13855 ROGERS DR
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:MN
Mailing Address - Zip Code:55374-4408
Mailing Address - Country:US
Mailing Address - Phone:763-428-6080
Mailing Address - Fax:763-428-9170
Practice Address - Street 1:13855 ROGERS DR
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:MN
Practice Address - Zip Code:55374-4408
Practice Address - Country:US
Practice Address - Phone:763-428-6080
Practice Address - Fax:763-428-9170
Is Sole Proprietor?:No
Enumeration Date:2014-02-17
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN115542183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist