Provider Demographics
NPI:1598242158
Name:TREMPE, THOMAS M (PHARMD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:M
Last Name:TREMPE
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 1:3226 142ND AVE NE
Mailing Address - Street 2:
Mailing Address - City:HAM LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55304-6854
Mailing Address - Country:US
Mailing Address - Phone:612-986-9000
Mailing Address - Fax:
Practice Address - Street 1:2101 2ND AVE SE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MN
Practice Address - Zip Code:55008-4137
Practice Address - Country:US
Practice Address - Phone:763-689-0605
Practice Address - Fax:763-689-0605
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-25
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN117236183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN117236OtherLICENSE