| NPI | 1104360973 |
|---|---|
| Doing Business As | PARK NICOLLET PHARMACY #87017 |
| Entity Type | Organization |
| Authorized Contact | DAVID BUSCH VP Pharmacy Operations 952-967-6876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2020-06-08 |