Provider Demographics
NPI:1851268122
Name:FRUNWI, CHARLES
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:FRUNWI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6033 INSPIRE AVE S
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55016-5520
Mailing Address - Country:US
Mailing Address - Phone:321-230-3426
Mailing Address - Fax:
Practice Address - Street 1:6033 INSPIRE AVE S
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55016-5520
Practice Address - Country:US
Practice Address - Phone:321-230-3426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-21
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN127153183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist