Organization
MOKA PHARMACY INC
Active
Other names
Moka Pharmacy Inc
Organization subpart
No
Provider details
NPI number
Authorized official
TUSMO JAMA (PHARMACIST)
(612) 874-0573
Entity
Organization
Contact information
Practice address
1515 E FRANKLIN AVE, MINNEAPOLIS, MN 55404-2137
(612) 874-0575
(612) 874-0582
Mailing address
1515 E FRANKLIN AVE, MINNEAPOLIS, MN 55404-2137
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
263331
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2429505
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/26/2009
Last updated
04/29/2009
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