Provider Demographics
NPI:1366776361
Name:RAPOVICH, TARA JEAN (PHARM D RPH)
Entity type:Individual
Prefix:MS
First Name:TARA
Middle Name:JEAN
Last Name:RAPOVICH
Suffix:
Gender:F
Credentials:PHARM D RPH
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:JEAN
Other - Last Name:AMMERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 W CENTER ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55902-3003
Mailing Address - Country:US
Mailing Address - Phone:507-266-7416
Mailing Address - Fax:
Practice Address - Street 1:200 1ST ST SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55905-3003
Practice Address - Country:US
Practice Address - Phone:507-284-2511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-23
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN119863183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist