Organization
PREFERRED CHOICE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY PROSCH RPH (PRESIDENT)
(651) 582-0286
Entity
Organization
Contact information
Practice address
900 LONG LAKE RD, STE 150, NEW BRIGHTON, MN 55112-6428
(651) 636-3919
(651) 582-0290
Mailing address
900 LONG LAKE RD, STE 150, NEW BRIGHTON, MN 55112-6428
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
262161
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2425090
OTHER ID NUMBER
—
Enumeration date
03/08/2007
Last updated
10/18/2007
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