Provider Demographics
NPI:1801408174
Name:COFFMAN, CURTIS PHILIP (RPH)
Entity Type:Individual
Prefix:MR
First Name:CURTIS
Middle Name:PHILIP
Last Name:COFFMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2387 HIGHWAY 10
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55112-4967
Mailing Address - Country:US
Mailing Address - Phone:763-784-8925
Mailing Address - Fax:763-784-8951
Practice Address - Street 1:2387 HIGHWAY 10
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55112-4967
Practice Address - Country:US
Practice Address - Phone:763-784-8925
Practice Address - Fax:763-784-8951
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN114826183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist