Provider Demographics
NPI:1164937926
Name:FINCH, IRA LEON JR
Entity Type:Individual
Prefix:
First Name:IRA
Middle Name:LEON
Last Name:FINCH
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1839 NICOLLET AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-3745
Mailing Address - Country:US
Mailing Address - Phone:612-823-2947
Mailing Address - Fax:
Practice Address - Street 1:1839 NICOLLET AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-3745
Practice Address - Country:US
Practice Address - Phone:612-823-2947
Practice Address - Fax:612-823-2947
Is Sole Proprietor?:No
Enumeration Date:2017-12-02
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN113872183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN113872OtherMINNESOTA BOARD OF PHARMACY