Organization
CHILDREN'S HEALTH CARE
Active
Other names
Children's Hospitals and Clinics of Minnesota
Organization subpart
No
Provider details
NPI number
Authorized official
CHESTEVIA GIBSON PHARMD (DIRECTOR PHARMACY SERVICES)
(612) 813-7292
Entity
Organization
Contact information
Practice address
2530 CHICAGO AVE SOUTH, CSC 225, MINNEAPOLIS, MN 55404-4289
(612) 813-7290
Mailing address
PO BOX 860123, MINNEAPOLIS, MN 55486-0123
(612) 813-7290
(612) 813-7296
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
Primary
—
—
Other
Enumeration date
03/08/2023
Last updated
03/08/2023
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