| NPI | 1679615629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODI LYNN BEYER Pharmacist In Charge 218-643-5411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 261997) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2020-08-22 |