Organization
SERVICE DRUG OF BRAINERD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRECIA WIEWEL II RPH (PHARMACIST IN CHARGE)
(218) 829-3664
Entity
Organization
Contact information
Practice address
218 W WASHINGTON ST, BRAINERD, MN 56401-2922
(218) 829-3664
(218) 829-8979
Mailing address
218 W WASHINGTON ST, BRAINERD, MN 56401-2922
(218) 829-3664
(218) 829-8979
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
2604048
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2414352
NABP
MN
Enumeration date
07/15/2006
Last updated
08/22/2020
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