Provider Demographics
NPI:1831458710
Name:TORFIN, GRANT (RPH)
Entity Type:Individual
Prefix:
First Name:GRANT
Middle Name:
Last Name:TORFIN
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 1:3235 LAKE ANDREW RD SW
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-6137
Mailing Address - Country:US
Mailing Address - Phone:320-762-8116
Mailing Address - Fax:
Practice Address - Street 1:3235 LAKE ANDREW RD SW
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-6137
Practice Address - Country:US
Practice Address - Phone:320-762-8116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-11
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP3929183500000X
MN112672183500000X
ND3569183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist