Healthcare Provider Details

I. General information

NPI: 1639088958
Provider Name (Legal Business Name): MATHEW RYAN HINTZ PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 1ST DR NW
AUSTIN MN
55912-2941
US

IV. Provider business mailing address

1000 1ST DR NW PHARMACY
AUSTIN MN
55912-2941
US

V. Phone/Fax

Practice location:
  • Phone: 515-205-1879
  • Fax:
Mailing address:
  • Phone: 507-434-1422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number127448
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: