| NPI | 1992202048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEWODROS GEMEDA Owner 612-315-5687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2019-06-11 |