Organization
GREEN LAKE THRIFTY WHITE DRUG INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS MERTEN (OWNER)
(320) 796-2103
Entity
Organization
Contact information
Practice address
300 HIGHWAY 23 STE 4, SPICER, MN 56288-9677
(320) 796-2103
(320) 796-4060
Mailing address
300 HIGHWAY 23 STE 4, SPICER, MN 56288-9677
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
2616447
MN
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2418881
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/31/2006
Last updated
09/11/2025
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