Healthcare Provider Details

I. General information

NPI: 1558284059
Provider Name (Legal Business Name): COLE THOMAS MERRILL PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 EXCELSIOR BLVD
SAINT LOUIS PARK MN
55426-4702
US

IV. Provider business mailing address

850 SHENANDOAH DR APT D385
SHAKOPEE MN
55379-5163
US

V. Phone/Fax

Practice location:
  • Phone: 952-993-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number127441
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: