| NPI | 1598453490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY ELAINE TRACY Chief Compliance Officer 651-964-9952 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2023-04-27 |
| Last Update Date | 2023-04-27 |