| NPI | 1861496895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC MARLO BRANDREIT Pharmacist Pharm D 320-839-3825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MN 260519-9) |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2020-08-22 |