| NPI | 1447974597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAY KOU VANG Owner 612-708-0159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2023-04-16 |