Provider Demographics
NPI:1497053797
Name:HMIELEWSKI, TREVOR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:
Last Name:HMIELEWSKI
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 1:200 PIONEER TRL
Mailing Address - Street 2:
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-1169
Mailing Address - Country:US
Mailing Address - Phone:952-448-9809
Mailing Address - Fax:952-361-9108
Practice Address - Street 1:200 PIONEER TRL
Practice Address - Street 2:
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-1169
Practice Address - Country:US
Practice Address - Phone:952-448-9809
Practice Address - Fax:952-361-9108
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-10
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA213171835P0018X
MN1204661835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist