William Supalla, RPH

NPI 1760520373 · on the registry since 2007

Practice

Address: 322 S State St
Five Lakes Centre
Fairmont, MN 56031
Phone: (507) 238-2797
Fax: (507) 238-4701
Organisation at this address: Astrup Drug Inc
Custom Clinic, P.A.
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 4

Registry record

Primary taxonomy: Pharmacist
183500000X
Licence states on file: MN
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2007-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota