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Organization
FOSSTON LONG TERM CARE PHARMACY, INC
Active
Organization
FOSSTON LONG TERM CARE PHARMACY, INC
Active
Other names
Nord's Long Term Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RUTH FONDER PHARM D (PRESIDENT)
(218) 435-6646
Entity
Organization
Contact information
Practice address
115 JOHNSON AVE N STE A, FOSSTON, MN 56542-1327
(218) 435-6646
(218) 435-1564
Mailing address
115 JOHNSON AVE N STE A, FOSSTON, MN 56542-1327
(218) 435-6646
(218) 435-1564
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
264082
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558704502
—
MN
Enumeration date
04/09/2013
Last updated
01/20/2017
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