DR. DUSTIN ADAM KAKACH (NPI# 1548751654) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548751654 |
| Entity Type | Individual |
| Full Name | DR. DUSTIN ADAM KAKACH |
| Credential | PHARMD |
| Practice Address |
600 County Hwy 10 Blaine MN 55434 |
| Mailing Address |
4820 Park Commons Dr Apt 228 Saint Louis Park MN 55416-2641 |
| Practice Telephone | 7637869081 |
| Mailing Telephone | 9524061321 |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2018-05-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
123598 | MN | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | PHARMACIST LICENSE | 123598 | 01 |
| Street Address |
600 COUNTY HWY 10 |
| City | BLAINE |
| State | MN |
| Zip Code | 55434 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740892181 | Kelsey Joliff | Pharmacist | 600 County Hwy 10, Blaine, MN 55434 | 2020-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023628591 | Rahul Farmah | Optometrist | 680 Hwy 10 Ne, Blaine, MN 55434 | 2020-08-08 |
| 1033770714 | Enduring Home Health Care Corp | Home Health | 10812 Fillmore Street, Blaine, MN 55434 | 2019-06-24 |
| 1932762408 | Vital Agency LLC | In Home Supportive Care | 12864 Fillmore Street Ne, Blaine, MN 55434 | 2019-04-19 |
| 1598253445 | Jacob James Apland | Behavioral Analyst | 12401 Oak Park Blvd Ne Apt 316, Blaine, MN 55434 | 2018-04-26 |
| 1962921924 | Mw Minnetonka Operating LLC | Assisted Living Facility | 1005 Paul Parkway Ne, Blaine, MN 55434 | 2017-09-11 |
| 1922526961 | Blaine Asc, LLC | Clinic/Center | 11225 Ulysses Street Northeast, Blaine, MN 55434 | 2017-08-30 |
| 1629591334 | Minnehaha Transportation Inc | Non-emergency Medical Transport (VAN) | 2507 Walnut St, Roseville, MN 55434 | 2017-07-25 |
| 1629590872 | Alexandra Staum Reif | Pediatrics | 11107 Ulysses Street Ne, Suite 100, Blaine, MN 55434 | 2017-07-10 |
| 1962939546 | Nicolette Gengel | Dentist | 1384 109th Ave Ne Ste 200, Blaine, MN 55434 | 2017-05-15 |
| 1235681958 | Supervalu Pharmacies Inc | Durable Medical Equipment & Medical Supplies | 10881 University Ave Ne, Blaine, MN 55434 | 2016-10-28 |
| Find all providers in zip 55434 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356672091 | George Muthiaru Mburu | Pharmacist | 10905 Ulysses St Ne, Blaine, MN 55434-3827 | 2010-01-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417587205 | Pain Partners LLC | Pharmacist | 15225 Wild Wings Court, Minnetonka, MN 55345 | 2020-01-21 |
| 1174160832 | Susan Jacobson | Pharmacist | One Veterans Drive (119), Minneapolis, MN 55417 | 2019-12-02 |
| 1942789912 | Savannah Danielle Miller | Pharmacist | 323 S Minnesota Street, Crookston, MN 56716 | 2018-08-10 |
| 1831642214 | Jennifer Franke | Pharmacist | 24760 Hospital Rd., Red Lake, MN 56671 | 2016-08-02 |
| 1922479062 | Shelby Setniker-eschiti | Pharmacist | 2172 German St, Maplewood, MN 55109-2853 | 2015-10-15 |
| 1336530310 | Audrey Jean Twit | Pharmacist | 523 North Third Street, Essentia Health St Joseph's Medical Center, Brainerd, MN 56401 | 2015-02-11 |
| 1215349584 | Stephen Destefano | Pharmacist | 31419 131st Street, Princeton, MN 55371 | 2014-05-21 |
| 1104259795 | Megan Nimke | Pharmacist | 345 Smith Ave North Pharmacy Department, Children's Hospital & Clinics of Minnesota Pharmacy Dep, St. Paul, MN 55102 | 2013-08-19 |
| 1790033363 | Mary Sauer | Pharmacist | 5615 Xerxes Ave N Ste D, Brooklyn Center, MN 55430-2819 | 2012-08-29 |
| 1982989554 | Ole Olson | Pharmacist | 3444 Limerick Ln Ne, Rochester, MN 55906-8038 | 2011-10-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.