Provider Demographics
NPI:1154676708
Name:HOFFMAN, EMILY A (PHARMD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:A
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11200 XENIA AVE N
Mailing Address - Street 2:
Mailing Address - City:CHAMPLIN
Mailing Address - State:MN
Mailing Address - Zip Code:55316-3489
Mailing Address - Country:US
Mailing Address - Phone:612-518-0174
Mailing Address - Fax:
Practice Address - Street 1:851 W 78TH ST
Practice Address - Street 2:T0862
Practice Address - City:CHANHASSEN
Practice Address - State:MN
Practice Address - Zip Code:55317-9579
Practice Address - Country:US
Practice Address - Phone:952-470-0206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN120928183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist