Organization
LAKES SNYDER DRUG, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAN JOHN HAGEN RPH (PRESIDENT)
(651) 464-5518
Entity
Organization
Contact information
Practice address
808 LAKE ST S, FOREST LAKE, MN 55025-2614
(651) 464-5518
(651) 464-1513
Mailing address
808 LAKE ST S, FOREST LAKE, MN 55025-2614
(651) 464-5518
(651) 464-1513
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
261427-4
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2422107
NCPDP
MN
Enumeration date
10/23/2006
Last updated
02/14/2008
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