| NPI | 1639622947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRUNG NGUYEN Owner 651-600-3988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MN 265127) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| Enumeration Date | 2016-08-03 |
| Last Update Date | 2016-08-24 |