Provider Demographics
NPI:1427327311
Name:FREMMING, RYAN MICHAEL (PHARMD)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:MICHAEL
Last Name:FREMMING
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 1:16011 INGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-8769
Mailing Address - Country:US
Mailing Address - Phone:952-250-4474
Mailing Address - Fax:
Practice Address - Street 1:4916 FRANCE AVE S
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55410-1758
Practice Address - Country:US
Practice Address - Phone:952-927-5548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN120361183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist