Organization
GOODRICH PHARMACY INC
Active
Other names
GOODRICH PHARMACY ANDOVER
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT MICHAEL BENSON (PRESIDENT.)
(763) 434-1901
Entity
Organization
Contact information
Practice address
15245 BLUEBIRD ST NW, STE B, ANDOVER, MN 55304
(763) 434-1901
(763) 587-4694
Mailing address
2621 GREENHAVEN RD STE 1, ANOKA, MN 55303-5566
(763) 421-4766
(763) 421-9229
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
265079
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2047848
PK
—
05
—
781019900
—
MN
Enumeration date
08/31/2006
Last updated
07/06/2023
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