| NPI | 1780727958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHESTEVIA GIBSON Outpatient Pharmcy Manager 612-813-7290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MN 2009915) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2022-10-31 |