| NPI | 1003260969 |
|---|---|
| Doing Business As | MARKETPLACE PHARMACY #2583 |
| Entity Type | Organization |
| Authorized Contact | CHAD NELLIS Director Of Pharmacy 320-534-2743 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WI 9403-42) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2023-10-02 |