# THE FOUNDATION FOR HEALTH CARE CONTINUUMS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** COUNTRY MANOR LTC PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013023787
- **Authorized official:** BRIAN KELM (CEO)
- **Authorized official phone:** (320) 258-8985

## Contact information

- **Practice address:** 520 1ST ST NE, SUITE A, SARTELL, MN 56377-1274
- **Practice address phone:** (320) 255-0801
- **Practice address fax:** (320) 255-5158
- **Mailing address:** 520 1ST ST NE, SUITE A, SARTELL, MN 56377-1274

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | 262882 | MN | Yes |

## Other

- **Enumeration date:** 08/22/2006
- **Last updated:** 03/26/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2427739 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |