Healthcare Provider Details

I. General information

NPI: 1205181278
Provider Name (Legal Business Name): SARA HOVLAND PHARMD, MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2012
Last Update Date: 07/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4802 HWY 101 TARGET #1356
MINNETONKA MN
55345
US

IV. Provider business mailing address

4802 HWY 101 TARGET #1356
MINNETONKA MN
55345
US

V. Phone/Fax

Practice location:
  • Phone: 952-401-3814
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number118972
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: