# MINNESOTA STATE COLLEGES AND UNIVERSITIES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** HEALTH SERVICES PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487636213
- **Authorized official:** ANN JOHNSON BS (PHARMACY MANAGER, PIC)
- **Authorized official phone:** (507) 389-2483

## Contact information

- **Practice address:** 21 CARKOSKI CMNS, MINNESOTA STATE UNIVERSITY, MANKATO, MANKATO, MN 56001-6030
- **Practice address phone:** (507) 389-2483
- **Practice address fax:** (507) 389-2206
- **Mailing address:** 21 CARKOSKI CMNS, 600 MAYWOOD AVE, MANKATO, MN 56001-6030
- **Mailing address phone:** (507) 389-2483
- **Mailing address fax:** (507) 389-2206

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 200808 | MN | Yes |
| 3336C0002X | Clinic Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 11/17/2005
- **Last updated:** 05/01/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2044574 | PK | — |
| 05 | — | 7773137 | — | MN |