| NPI | 1902480650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD NELLIS Director Of Pharmacy 320-534-2743 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2021-05-10 |
| Last Update Date | 2024-05-20 |