Organization
MICHAEL L VETTEL
Active
Other names
THE PHARMACY SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL L VETTEL (OWNER)
(218) 732-3351
Entity
Organization
Contact information
Practice address
100 8TH ST E, PARK RAPIDS, MN 56470-1699
(218) 732-3351
Mailing address
100 8TH ST E, PARK RAPIDS, MN 56470-1699
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
259954
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
716057700
—
MN
Enumeration date
02/07/2007
Last updated
06/18/2008
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