| NPI | 1558397232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA BERGQUIST Pharmasist In Charge 218-694-6501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MN 2057721) |
| Additional Taxonomies | 3336I0012X Pharmacy, Institutional Pharmacy |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2020-08-22 |