NPI 1003219759

Jerome Mauro

Practitioner Pharmacist Baxter, MN

Practice location

Address: 14546 Dellwood Dr, Baxter, MN 56425-9744
Phone: (218) 828-9219
Fax: (218) 828-9219

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 122023 (MN)

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Registry record

NPI: 1003219759
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 Oct 2014
Record last updated: 8 Oct 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.