| NPI | 1184700049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA O'CONNELL Manager, Managed Care 651-779-4023 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2024-04-26 |