NPI 1043659451

Bonita Lynne Moger, RPH

Practitioner Pharmacist Grand Rapids, MN

Practice location

Address: 2026 S Pokegama Ave, Grand Rapids, MN 55744-4288
Phone: (218) 326-9431
Fax: (218) 326-9433

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 115670 (MN)

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Registry record

NPI: 1043659451
Entity type: Individual
Sex (as registered): Female
NPI issued: 19 Jun 2013
Record last updated: 19 Jun 2013

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.