| NPI | 1508630112 |
|---|---|
| Doing Business As | LONGBELLA DRUG BY LAKEWOOD HEALTH SYSTEM - STAPLES CLINIC |
| Entity Type | Organization |
| Authorized Contact | JOSEPH REYCRAFT CFO 218-894-8194 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2023-11-14 |
| Last Update Date | 2023-11-14 |