| NPI | 1285383190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEEQ YUSSUF MOHAMMED Pharmacist In Charge (PIC) 612-644-8142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2022-03-20 |
| Last Update Date | 2022-03-20 |