| NPI | 1033135611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRECIA WIEWEL Pharmacist In Charge 218-829-3664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MN 2604048) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2020-08-22 |