| NPI | 1174286728 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE MCCABE Secretary 952-935-1191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy |
| Enumeration Date | 2021-10-20 |
| Last Update Date | 2026-05-07 |