Provider Demographics
NPI:1457117202
Name:RATHSACK, CARA CHERMAK (RPH)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:CHERMAK
Last Name:RATHSACK
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 1:9035 DOUGLAS DR
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55347-3359
Mailing Address - Country:US
Mailing Address - Phone:612-910-0771
Mailing Address - Fax:
Practice Address - Street 1:12011 TECHNOLOGY DR
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-3620
Practice Address - Country:US
Practice Address - Phone:952-943-4828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN117413-9208U00000X, 1835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No208U00000XAllopathic & Osteopathic PhysiciansClinical Pharmacology