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Organization
THE FOUNDATION FOR HEALTH CARE CONTINUUMS
Active
Organization
THE FOUNDATION FOR HEALTH CARE CONTINUUMS
Active
Other names
COUNTRY MANOR LTC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN KELM (CEO)
(320) 258-8985
Entity
Organization
Contact information
Practice address
520 1ST ST NE, SUITE A, SARTELL, MN 56377-1274
(320) 255-0801
(320) 255-5158
Mailing address
520 1ST ST NE, SUITE A, SARTELL, MN 56377-1274
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
262882
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2427739
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/22/2006
Last updated
03/26/2010
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