Provider Demographics
NPI:1790869832
Name:DOHMAN, TAMMIE K (RPH)
Entity Type:Individual
Prefix:
First Name:TAMMIE
Middle Name:K
Last Name:DOHMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6237 7TH ST SW
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-7610
Mailing Address - Country:US
Mailing Address - Phone:218-233-7101
Mailing Address - Fax:701-234-3330
Practice Address - Street 1:MERITCARE PHARMACY
Practice Address - Street 2:801 BROADWAY N
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58122-0001
Practice Address - Country:US
Practice Address - Phone:701-234-2132
Practice Address - Fax:701-234-2433
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4014183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist