NPI | 1316562143 |
---|---|
Entity Type | Organization |
Authorized Contact | KECIA ANDERSON Pharmacist In Charge 612-386-9483 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
3336S0011X Pharmacy, Specialty Pharmacy | |
332B00000X Durable Medical Equipment & Medical Supplies | |
333600000X Pharmacy | |
Enumeration Date | 2020-06-08 |
Last Update Date | 2020-11-02 |