Provider Demographics
NPI:1316259161
Name:KING, LAWRENCE DANIEL (PHARMD)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:DANIEL
Last Name:KING
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 2ND AVE S STE 1300
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55402-3244
Mailing Address - Country:US
Mailing Address - Phone:612-255-3633
Mailing Address - Fax:
Practice Address - Street 1:900 2ND AVE S STE 1300
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55402-3244
Practice Address - Country:US
Practice Address - Phone:612-255-3633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-09
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054629183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist