Healthcare Provider Details

I. General information

NPI: 1285648246
Provider Name (Legal Business Name): THOMAS ZASKE PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 VETERANS DR
SAINT CLOUD MN
56303-2015
US

IV. Provider business mailing address

3228 OLD STONE WAY NE
SAUK RAPIDS MN
56379
US

V. Phone/Fax

Practice location:
  • Phone: 320-255-6465
  • Fax: 320-255-6360
Mailing address:
  • Phone: 320-654-9787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number116338-6
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: