| NPI | 1497838759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN JOHN HAGEN President 651-464-5518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MN 261427-4) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2008-02-14 |