Organization
AITKIN PHARMACY SERVICES, LLC
Active
Other names
Thrifty White Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW J HUTERA (CEO)
(715) 808-0873
Entity
Organization
Contact information
Practice address
25 2ND STREET, NE, AITKIN, MN 56431
(218) 927-3754
(218) 927-6349
Mailing address
901 4TH STREET, SUITE 170, HUDSON, WI 54016
(715) 808-0873
(715) 953-4201
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
263647
MN
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
263647
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2415443
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
551060100
—
MN
Enumeration date
08/31/2006
Last updated
07/31/2012
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