Provider Demographics
NPI:1952658239
Name:HASSAN, EMAHN TAHIR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:EMAHN
Middle Name:TAHIR
Last Name:HASSAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12501 PORTLAND AVE APT 304
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-7506
Mailing Address - Country:US
Mailing Address - Phone:612-598-5335
Mailing Address - Fax:
Practice Address - Street 1:10520 FRANCE AVE S
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431-3573
Practice Address - Country:US
Practice Address - Phone:952-888-4310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN120997183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist