Provider Demographics
NPI:1235740333
Name:MEINDERS, TRAVIS (PHARMD)
Entity Type:Individual
Prefix:
First Name:TRAVIS
Middle Name:
Last Name:MEINDERS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 OXFORD ST
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:56187-1761
Mailing Address - Country:US
Mailing Address - Phone:507-372-7496
Mailing Address - Fax:
Practice Address - Street 1:1321 OXFORD ST
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:MN
Practice Address - Zip Code:56187-1761
Practice Address - Country:US
Practice Address - Phone:507-372-7496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN123887183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist