Organization
MINNESOTA DRUG ACQUISITION CO LLC
Active
Other names
Wolff Drug
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH KEAVENY (PRESIDENT)
(612) 227-7811
Entity
Organization
Contact information
Practice address
207 MAIN ST, PIERZ, MN 56364
(320) 468-6482
(320) 468-0041
Mailing address
7645 E 63RD ST, STE 105, TULSA, OK 74133-1208
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
263320
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2418158
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
526058200
—
MN
Enumeration date
12/01/2006
Last updated
08/05/2010
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