Provider Demographics
NPI:1023135217
Name:RX ARTISANS, INC.
Entity type:Organization
Organization Name:RX ARTISANS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANELLE
Authorized Official - Middle Name:J
Authorized Official - Last Name:WOLF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-249-9726
Mailing Address - Street 1:1421 WAYZATA BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-1939
Mailing Address - Country:US
Mailing Address - Phone:952-249-9726
Mailing Address - Fax:952-249-9727
Practice Address - Street 1:1421 WAYZATA BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-1939
Practice Address - Country:US
Practice Address - Phone:952-249-9726
Practice Address - Fax:952-249-9727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN26198713336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN2424391OtherNCPDP
MN2619871OtherMN PHARMACY LICENSE
MNBR7150864OtherDEA