Provider Demographics
NPI:1831786342
Name:TRANBY, WADE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:WADE
Middle Name:
Last Name:TRANBY
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 1:1940 CLIFF LAKE RD STE 2
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-5263
Mailing Address - Country:US
Mailing Address - Phone:651-454-5150
Mailing Address - Fax:651-686-5923
Practice Address - Street 1:1940 CLIFF LAKE RD STE 2
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-5263
Practice Address - Country:US
Practice Address - Phone:651-454-5150
Practice Address - Fax:651-686-5923
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN115389183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist