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General NPI Number Information
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NPI Number | 1861014169
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Entity Type | Individual
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Provider Name | MR. TERRANCE THURMER JR.
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Gender | Male
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Dates
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Enumeration Date | 05/11/2020
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Last Update Date | 05/11/2020
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Provider Practice Location Address
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Address Line | 2420 W DIVISION ST
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City | SAINT CLOUD
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State | MN
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Zip | 56301-3926
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Country | US
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Telephone | 320-253-5366
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Fax |
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Provider Business Mailing Address
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Address Line | 18390 TROTT BROOK PKWY NW
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City | ELK RIVER
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State | MN
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Zip | 55330-4660
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Country | US
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Telephone | 763-245-8796
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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 | 117894
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License Number State | MN
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