Individual provider Active NPI

Thakul None Rattanasuwan, PHARMD

  • Ambulatory Care Pharmacist
  • Paynesville, MN
National Provider Identifier
1225550858
Registry record updated Jul 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
123417 Issued in MN
Practice address
200 W 1St St
Paynesville, MN 56362-1445
Phone
(320) 243-3767
NPI assigned
Jul 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Pharmacist 1835P2201X 123417 MN Primary

Addresses

Primary practice location

200 W 1St St
Paynesville, MN 56362-1445

Mailing address

245 E State Highway 55 Apt 307
Paynesville, MN 56362-2074
Phone (352) 215-2025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
123417MNMDAmbulatory Care Pharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499990400000",
    "number": "1225550858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 E STATE HIGHWAY 55 APT 307",
            "city": "PAYNESVILLE",
            "state": "MN",
            "postal_code": "563622074",
            "telephone_number": "352-215-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W 1ST ST",
            "city": "PAYNESVILLE",
            "state": "MN",
            "postal_code": "563621445",
            "telephone_number": "320-243-3767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATTANASUWAN",
        "first_name": "THAKUL",
        "middle_name": "NONE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-14",
        "last_updated": "2017-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "MN",
            "license": "123417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paynesville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.