| NPI | 1376829267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA LEE PEREZ Pharmacy Technician 763-425-5300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MN 705957) |
| Enumeration Date | 2011-10-24 |
| Last Update Date | 2011-10-24 |