| NPI | 1528222940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN PACULT President 651-894-4785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: MN 263221) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2008-08-12 |