| NPI | 1639566649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KY NOUKY FANG Pharmacist 651-447-7113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MN 118487) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: MN 118487) |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2015-04-17 |