Organization
LAKE CEDAR PHARMACY
Active
Other names
Lake Cedar Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
SAIDA MOHAMED (PHARMACIST IN CHARGE)
(612) 987-2002
Entity
Organization
Contact information
Practice address
2423 E FRANKLIN AVE, MINNEAPOLIS, MN 55406-1026
(612) 353-5532
(612) 353-5537
Mailing address
526 121ST AVE NE, BLAINE, MN 55434-3380
(763) 222-4199
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
263276
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2118628
PK
—
Enumeration date
01/21/2009
Last updated
11/01/2022
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