Organization
MINNESOTA STATE COLLEGES AND UNIVERSITIES
Active
Other names
HEALTH SERVICES PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ANN JOHNSON BS (PHARMACY MANAGER, PIC)
(507) 389-2483
Entity
Organization
Contact information
Practice address
21 CARKOSKI CMNS, MINNESOTA STATE UNIVERSITY, MANKATO, MANKATO, MN 56001-6030
(507) 389-2483
(507) 389-2206
Mailing address
21 CARKOSKI CMNS, 600 MAYWOOD AVE, MANKATO, MN 56001-6030
(507) 389-2483
(507) 389-2206
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
200808
MN
3336C0002X
Clinic Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2044574
PK
—
05
—
7773137
—
MN
Enumeration date
11/17/2005
Last updated
05/01/2017
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