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Organization
WEST SIDE COMMUNITY HEALTH SERVICES INC
Active
Organization
WEST SIDE COMMUNITY HEALTH SERVICES INC
Active
Other names
EAST SIDE FAMILY CLINIC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DEANNA GENGLER (PIC)
(651) 793-2245
Entity
Organization
Contact information
Practice address
895 7TH ST E, SAINT PAUL, MN 55106-3871
(651) 793-2250
(651) 793-2240
Mailing address
PO BOX 9830, SALT LAKE CITY, UT 84109-9830
(651) 793-2250
(651) 793-2240
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
Primary
263192
MN
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2049696
PK
—
Enumeration date
06/30/2008
Last updated
06/22/2015
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