MEDICARE: DR. TODD D LEMKE PHARMD CDE

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
1	1835P1200X	Pharmacotherapy Pharmacist	1168404	MN

General Provider Information

NPI Number	:	1760485908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TODD D LEMKE PHARMD CDE

Provider Business Mailing Address
First Line	:	39250 647TH AVE
Second Line	:
City	:	WATKINS
State	:	MN
Zip	:	55389-5857
Country	:	US
Telephone Number	:	320-764-5332
Fax Number	:	320-243-7910

Provider Business Practice Location Address
First Line	:	200 FIRST ST W
Second Line	:
City	:	PAYNESVILLE
State	:	MN
Zip	:	56362
Country	:	US
Telephone Number	:	320-243-7772
Fax Number	:	320-243-7910

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	07/08/2007

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