Organization
TARGET
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA LEE PEREZ (PHARMACY TECHNICIAN)
(763) 425-5300
Entity
Organization
Contact information
Practice address
7535 W BROADWAY AVE, BROOKLYN PARK, MN 55428-1287
(763) 425-5300
(763) 425-5300
Mailing address
7535 W BROADWAY AVE, BROOKLYN PARK, MN 55428-1287
(763) 425-5300
(763) 425-5300
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
705957
MN
Other
Enumeration date
10/24/2011
Last updated
10/24/2011
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