Organization
COMMUNITY CARE PHARMACY PA
Active
Other names
COMMUNITY CARE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD WENSMENN PHARMD (PRESIDENT)
(320) 271-1135
Entity
Organization
Contact information
Practice address
102 2ND AVE NW, SAINT JOSEPH, MN 56374-4106
(320) 271-1135
(320) 271-1137
Mailing address
PO BOX 100, SAINT JOSEPH, MN 56374-0100
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2626385
MN
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2427018
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
01/23/2007
Last updated
09/12/2007
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