Organization
PINE MEDICAL CENTER
Active
Organization
PINE MEDICAL CENTER
Active
Parent organization
PINE MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
PINE MEDICAL CENTER
Authorized official
JIM KOPPEN (DIRECTOR OF PHARMACY)
(952) 653-2528
Entity
Organization
Contact information
Practice address
109 COURT AVE S, SANDSTONE, MN 55072-5120
(952) 653-2528
Mailing address
6501 CITY WEST PKWY, EDEN PRAIRIE, MN 55344-3248
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
11/19/2008
Last updated
11/19/2008
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