ETHAN JON HEIDORN PHARMD
NPI 1710561386
Pharmacist in St Louis Park, MN

Active since May 10, 2021
3601 HIGHWAY 100 S, ST LOUIS PARK, MN 55416(952) 926-8967 Get Directions Write a Review

NPPES record last updated: May 10, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ethan Jon Heidorn Pharmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHAN JON HEIDORN PHARMD (NPI 1710561386) is an individual pharmacist in St Louis Park, Minnesota, licensed in Minnesota (124875) and active in the NPI registry since May 2021.

NPPES Registry Identity

NPI1710561386
Entity TypeIndividualMale
Primary Taxonomy183500000X
Provider Legal NameETHAN JON HEIDORNCredential: PHARMD
Location Address3601 HIGHWAY 100 SSt Louis Park, MN 55416-2500
Mailing Address3601 Highway 100 SSt Louis Park, MN 55416-2500 · (952) 926-8967
Sole ProprietorYes
Enumeration DateMay 10, 2021
NPPES CertifiedMay 10, 2021
NPI 1710561386 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License Licensed in MN · 124875
Definition
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
3601 HIGHWAY 100 S, St Louis Park, MN 55416

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Optometrist
3601 HIGHWAY 100 S
ST LOUIS PARK, MN 55416
Pharmacist
3601 HIGHWAY 100 S
ST LOUIS PARK, MN 55416
Pharmacy
3601 HIGHWAY 100 S
ST LOUIS PARK, MN 55416
Pharmacist
3601 HIGHWAY 100 S
ST LOUIS PARK, MN 55416
Pharmacist
3601 HIGHWAY 100 S
ST LOUIS PARK, MN 55416
Pharmacist
3601 HIGHWAY 100 S
ST LOUIS PARK, MN 55416
Pharmacist
3601 HIGHWAY 100 S
ST LOUIS PARK, MN 55416
Optometrist
3601 HIGHWAY 100 S
ST LOUIS PARK, MN 55416

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Heidorn's NPI number?

The NPI number for Ethan Heidorn is 1710561386. It was assigned to this individual provider in the NPPES registry on May 10, 2021.

Where is Ethan Heidorn located?

Ethan Heidorn practices at 3601 Highway 100 S, St Louis Park, MN 55416. The listed phone number is (952) 926-8967.

What is Ethan Heidorn's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

When was this NPI record last updated?

The NPPES record for Ethan Heidorn was last updated on May 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.