| NPI | 1265450670 |
|---|---|
| Doing Business As | COUNTRY STORE AND PHARMACY |
| Entity Type | Organization |
| Authorized Contact | BRIAN C KELM CEO 320-253-1920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MN 261738-1) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2010-03-18 |