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Organization
MINNESOTA STATE COLLEGES AND UNIVERSITIES
Active
Organization
MINNESOTA STATE COLLEGES AND UNIVERSITIES
Active
Other names
HEALTH SERVICES PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ANN JOHNSON BS (PHARMACY MANAGER, PIC)
(507) 389-2483
Entity
Organization
Contact information
Practice address
21 CARKOSKI CMNS, MINNESOTA STATE UNIVERSITY, MANKATO, MANKATO, MN 56001-6030
(507) 389-2483
(507) 389-2206
Mailing address
21 CARKOSKI CMNS, 600 MAYWOOD AVE, MANKATO, MN 56001-6030
(507) 389-2483
(507) 389-2206
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
200808
MN
3336C0002X
Clinic Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2044574
PK
—
05
—
7773137
—
MN
Enumeration date
11/17/2005
Last updated
05/01/2017
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