| NPI | 1255610218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE SIMENSON Pharmacist 763-421-4788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: MN 263570) |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2011-08-09 |