Troy Thomas Atherton, PHARMD
Individual provider Active NPI Pharmacist · La Crescent, MN
NPI 1366065880 · NPPES record last updated May 19, 2020
Key facts
- NPI
- 1366065880
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 121168 (MN)
- Practice address
- 306 Main St # 103
La Crescent, MN 55947-1828 - Phone
- (507) 895-8784
- Fax
- (507) 895-4135
- NPI assigned
- May 19, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 121168 | MN | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 121168 | MN | Yes |
Addresses
Primary practice location
306 Main St # 103
La Crescent, MN 55947-1828
Mailing address
306 Main St # 103
La Crescent, MN 55947-1828
Phone (507) 895-8784
Other providers in La Crescent, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 19, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.