Organization
SHAKOPEE MDEWAKANTON SIOUX COMMUNITY
Active
Other names
SMSC PHARMACY, SHAKOPEE MDEWAKANTON SIOUX COMM PHCY
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM WEIERS RPH (PHARMACY DIRECTOR)
(952) 233-2900
Entity
Organization
Contact information
Practice address
15045 MYSTIC LAKE DR NW, PRIOR LAKE, MN 55372-9011
(952) 233-2900
(952) 233-8066
Mailing address
15045 MYSTIC LAKE DR NW, PRIOR LAKE, MN 55372-9011
(952) 233-2900
(952) 233-8066
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
262982
MN
3336C0002X
Clinic Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2049180
PK
—
Enumeration date
01/23/2007
Last updated
01/20/2025
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