| NPI | 1023610797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN W. TRUAX Member Manager 218-444-8217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 3336M0002X Pharmacy, Mail Order Pharmacy | |
| Enumeration Date | 2020-11-09 |
| Last Update Date | 2020-11-09 |