Organization
FOSSTON LONG TERM CARE PHARMACY, INC
Active
Other names
Nord's Long Term Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RUTH FONDER PHARM D (PRESIDENT)
(218) 435-6646
Entity
Organization
Contact information
Practice address
115 JOHNSON AVE N STE A, FOSSTON, MN 56542-1327
(218) 435-6646
(218) 435-1564
Mailing address
115 JOHNSON AVE N STE A, FOSSTON, MN 56542-1327
(218) 435-6646
(218) 435-1564
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
264082
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558704502
—
MN
Enumeration date
04/09/2013
Last updated
01/20/2017
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