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Organization
GOODRICH PHARMACY, INC.
Active
Organization
GOODRICH PHARMACY, INC.
Active
Other names
GOODRICH PHARMACY ELK RIVER
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE MARIE DAVIS (OWNER)
(763) 421-5540
Entity
Organization
Contact information
Practice address
530 3RD ST NW, ELK RIVER, MN 55330-1445
(763) 441-0764
(763) 587-4897
Mailing address
2621 GREENHAVEN RD STE 1, ANOKA, MN 55303-5566
(763) 441-0764
(763) 587-4897
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
Primary
265080
MN
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2046716
PK
—
05
—
606360800
—
MN
Enumeration date
08/31/2006
Last updated
07/06/2023
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