Provider Demographics
NPI:1235880881
Name:BHOBHO, TAFADZWA ELECK (PHARMD)
Entity Type:Individual
Prefix:
First Name:TAFADZWA
Middle Name:ELECK
Last Name:BHOBHO
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 1:813 DIAMOND RIDGE LN NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-6502
Mailing Address - Country:US
Mailing Address - Phone:612-913-6014
Mailing Address - Fax:
Practice Address - Street 1:495 W NORTH ST
Practice Address - Street 2:
Practice Address - City:OWATONNA
Practice Address - State:MN
Practice Address - Zip Code:55060-1107
Practice Address - Country:US
Practice Address - Phone:507-451-7886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN124367183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist