Individual
DR. PHEMELO B TSHANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
701 W BROADWAY AVE, MINNEAPOLIS, MN 55411-2611
(612) 302-8740
Mailing address
1294 FIFIELD PL, FALCON HEIGHTS, MN 55108-1103
(651) 646-8042
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
119580
MN
183500000X
Pharmacist
16433
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
119580
REGISTERED PHARMACIST LICENSE
MN
01
—
16433
REGISTERED PHARMACIST LICENSE
MD
Enumeration date
02/23/2007
Last updated
02/11/2010
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