| NPI | 1669544458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD PETTY Owner 320-760-8471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MN 262092) |
| Additional Taxonomies | 3336L0003X Pharmacy Long Term Care Pharmacy |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2010-11-09 |