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NPI Code Detail

MEDICARE: SPENCER TODD STROMBACK PHARM D.

MEDICARE: SPENCER TODD STROMBACK PHARM D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist123344MN

General Provider Information

NPI Number : 1558975821
Entity Type Code : Individual
Provider Name (Legal Business Name) : SPENCER TODD STROMBACK PHARM D.
Provider Business Mailing Address
First Line : 11401 MARKETPLACE DR N
Second Line :
City : CHAMPLIN
State : MN
Zip : 55316-3794
Country : US
Telephone Number : 763-427-6389
Fax Number : 763-427-2520
Provider Business Practice Location Address
First Line : 11401 MARKETPLACE DR N
Second Line :
City : CHAMPLIN
State : MN
Zip : 55316-3794
Country : US
Telephone Number : 763-427-6389
Fax Number : 763-427-2520
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2020
Last Update Date : 09/03/2020

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Directions to “ SPENCER TODD STROMBACK PHARM D.” Practice Location

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