| NPI | 1114036241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD W TIMM President 612-379-3578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: MN 6700564) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2008-11-25 |