| NPI | 1164676482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE MARIE CHEZICK Director Of Pharmacy 952-653-2528 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2008-11-13 |
| Last Update Date | 2021-06-02 |