Healthcare Provider Details

I. General information

NPI: 1700163789
Provider Name (Legal Business Name): VICTORIA RUTH HOFFMAN RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2011
Last Update Date: 11/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5825 CAHILL AVE
INVER GROVE HEIGHTS MN
55076-1515
US

IV. Provider business mailing address

5825 CAHILL AVE
INVER GROVE HEIGHTS MN
55076
US

V. Phone/Fax

Practice location:
  • Phone: 651-451-1503
  • Fax: 651-451-3650
Mailing address:
  • Phone: 651-451-1503
  • Fax: 651-451-3650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number116041
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: