Organization
NYC AND EZY CORP
Active
Other names
MAPLE PLAIN DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH REYCRAFT RPH (PRESIDENT)
(763) 479-1903
Entity
Organization
Contact information
Practice address
1500 HOWARD AVE, MAPLE PLAIN, MN 55359-9634
(763) 479-1903
(763) 479-6516
Mailing address
1500 HOWARD AVE, MAPLE PLAIN, MN 55359-9634
(763) 479-1903
(763) 479-6516
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
200719
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2406127
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
800760800
—
MN
Enumeration date
08/20/2006
Last updated
04/01/2011
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