Organization
LIEBE DRUG INC
Active
Other names
LIEBE DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN JOHNSON (MANAGER PHARMCIST)
(320) 695-2331
Entity
Organization
Contact information
Practice address
332 4TH BROADWAY, BROWNS VALLEY, MN 56219-0256
(320) 695-2331
(320) 695-2518
Mailing address
PO BOX K, BROWNS VALLEY, MN 56219-0256
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
260235
MN
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2417764
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
505058800
—
MN
05
—
8531902
—
SD
Enumeration date
06/13/2005
Last updated
01/25/2012
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