Organization
NUDAK VENTURES LLC
Active
Other names
NuCara Pharmacy #23
Organization subpart
No
Provider details
NPI number
Authorized official
LORI ANN WILLIS (ACQUISITIONS MANAGER)
(641) 366-3440
Entity
Organization
Contact information
Practice address
216 WASHBURNE AVE, PAYNESVILLE, MN 56362-1643
(320) 243-3781
(320) 243-2005
Mailing address
PO BOX 640, CONRAD, IA 50621-0640
(641) 366-3440
(641) 366-3442
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
263879
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639251424
—
MN
01
—
2134996
PK
—
Enumeration date
10/20/2006
Last updated
05/09/2025
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