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Organization

MINNESOTA STATE COLLEGES

Active
Other names
ST. CLOUD STATE UNIVERSITY HEALTH SERVICE
Organization subpart
No

Provider details

NPI number
Authorized official
LYNN LEAF BS (PHARMACIST IN CHARGE)
(320) 308-4852
Entity
Organization

Contact information

Practice address
251 6TH ST S, SAINT CLOUD, MN 56301-4491
(320) 308-4852
(320) 308-4878
Mailing address
720 4TH AVE S, SAINT CLOUD, MN 56301-4442
(320) 308-4852
(320) 308-4878

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0002X
Clinic Pharmacy
Primary
200814
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2045128
PK
05
492760500
MN
Enumeration date
03/11/2006
Last updated
10/11/2016
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