| NPI | 1932839370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN HEISER CEO 763-463-4485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 3336M0002X Pharmacy, Mail Order Pharmacy |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| 333600000X Pharmacy | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2022-06-16 |
| Last Update Date | 2022-08-02 |