Active NPI
Tong Vang
- Ambulatory Care Pharmacist
- White Bear Lake, MN
National Provider Identifier
1831978428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Pharmacist
- License
- 126277
- Practice address
- 1430 Highway 96 E
White Bear Lake, MN 55110-3653 - Phone
- (952) 967-6614
- NPI assigned
- Sep 25, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Care Pharmacist | 1835P2201X | 126277 | MN | Primary |
Addresses
Primary practice location
1430 Highway 96 E
White Bear Lake, MN 55110-3653
Mailing address
1530 Waterloo Ave
South St Paul, MN 55075-1049
Phone (651) 283-2754
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 126277 | MN | MD | Ambulatory Care Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695600000000",
"number": "1831978428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1530 WATERLOO AVE",
"city": "SOUTH ST PAUL",
"state": "MN",
"postal_code": "550751049",
"telephone_number": "651-283-2754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1430 HIGHWAY 96 E",
"city": "WHITE BEAR LAKE",
"state": "MN",
"postal_code": "551103653",
"telephone_number": "952-967-6614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANG",
"first_name": "TONG",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-09-25",
"last_updated": "2023-09-25",
"certification_date": "2023-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "MN",
"license": "126277",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in White Bear Lake, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.