Organization
WHITE DRUG ENTERPRISES INC
Active
Other names
WHITE DRUG #107
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE FROISTAD (LICENSING COORDINATOR)
(763) 513-4377
Entity
Organization
Contact information
Practice address
707 HIGHWAY 33 S STE 12, CLOQUET, MN 55720-2665
(218) 879-6768
(218) 879-5313
Mailing address
6701 EVENSTAD DR N STE 100, MAPLE GROVE, MN 55369-6013
(763) 513-4300
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
424-43
WI
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
260292
MN
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000021271WH
—
ND
01
—
2045738
PK
—
05
—
574857700
—
MN
Enumeration date
10/12/2006
Last updated
10/29/2024
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