Organization
GOODRICH PHARMACY, INC.
Active
Other names
GOODRICH PHARMACY ELK RIVER
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE MARIE DAVIS (OWNER)
(763) 421-5540
Entity
Organization
Contact information
Practice address
530 3RD ST NW, ELK RIVER, MN 55330-1445
(763) 441-0764
(763) 587-4897
Mailing address
2621 GREENHAVEN RD STE 1, ANOKA, MN 55303-5566
(763) 441-0764
(763) 587-4897
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
Primary
265080
MN
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2046716
PK
—
05
—
606360800
—
MN
Enumeration date
08/31/2006
Last updated
07/06/2023
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