| NPI | 1548608714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW DANIELSON Pharmacist In Charge 651-747-7596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MN 264119) |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2013-06-11 |