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General NPI Number Information
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NPI Number | 1144587916
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Entity Type | Individual
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Provider Name | LEROY MICHAEL THAEMERT RPH
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Gender | Male
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Dates
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Enumeration Date | 04/18/2012
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Last Update Date | 04/18/2012
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Provider Practice Location Address
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Address Line | 1248 TIERNEY DR
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City | NEW RICHMOND
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State | WI
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Zip | 54017-2500
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Country | US
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Telephone | 715-381-3826
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Fax |
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Provider Business Mailing Address
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Address Line | 1248 TIERNEY DR
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City | NEW RICHMOND
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State | WI
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Zip | 54017-2500
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Country | US
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Telephone | 715-381-3826
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 11260
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 114698
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | R5819
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License Number State | SD
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5357
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License Number State | ND
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Taxonomy #5
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 21386
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License Number State | IA
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Taxonomy #6
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 13590
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License Number State | NE
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Taxonomy #7
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 3431
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License Number State | WY
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