| NPI | 1003947102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY PROSCH President 651-582-0286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: MN 262161) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2007-10-18 |