| NPI | 1265447890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AHMEDFOWZ OSMAN Owner 612-333-2126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MN 2627122) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2020-08-22 |