| NPI | 1669574091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WARREN WORKER Pharmacy Manager Director 218-683-2725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0002X Pharmacy Clinic Pharmacy |
| 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MN 2615561) | |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2020-08-22 |