Organization
FIRST CHOICE PHARMACY OF JORDAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL REINHARDT (OWNER AND PHARM)
(952) 855-4381
Entity
Organization
Contact information
Practice address
165 WEST COMMERCE DRIVE, SUITE 110, BELLE PLAINE, MN 56011
(952) 855-4381
(952) 855-4015
Mailing address
165 WEST COMMERCE DRIVE, SUITE 110, BELLE PLAINE, MN 56011
(952) 855-4381
(952) 855-4015
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
265308
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568903532
—
MN
01
—
2167656
PK
—
Enumeration date
03/10/2017
Last updated
06/09/2017
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