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Organization
LEGACY APOTHECARY
Active
Organization
LEGACY APOTHECARY
Active
Other names
Waconia Clinic Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN LOEGERING PHARMD (PRESIDENT)
(651) 334-7322
Entity
Organization
Contact information
Practice address
430 W STATE HIGHWAY 5, WACONIA, MN 55387-1723
(952) 442-3274
(952) 442-3284
Mailing address
430 W STATE HIGHWAY 5, WACONIA, MN 55387-1723
(651) 334-7322
(952) 442-3284
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
617666200
—
MN
Enumeration date
11/13/2018
Last updated
11/13/2018
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