Organization
CENTRACARE PHARMACY SERVICES LLC
Active
Other names
CENTRACARE PHARMACY NORTHWAY
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH KARSKY RPH (COORDINATOR RETAIL PHARM. SE)
(320) 251-2700
Entity
Organization
Contact information
Practice address
1555 NORTHWAY DR STE 150, SAINT CLOUD, MN 56303-4912
(320) 240-3160
(320) 255-5876
Mailing address
1555 NORTHWAY DR, SUITE 150, SAINT CLOUD, MN 56303-4555
(320) 240-3160
(320) 255-5876
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
261081
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2047034
PK
—
05
—
649822100
—
MN
Enumeration date
04/25/2006
Last updated
07/05/2016
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