| NPI | 1700872280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP HOMMERDING Owner 507-289-3901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: MN 264485) |
| 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: MN 264484) | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: MN 265449) | |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2022-07-21 |