Organization
CHILDRENS HEALTH CARE
Active
Other names
Children's Hospital and Clinics
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM BUNZLI RPH (MGR ST.PAUL PHARMACY)
(651) 220-6806
Entity
Organization
Contact information
Practice address
345 SMITH AVE N, SAINT PAUL, MN 55102-2346
(651) 220-6963
(651) 220-6966
Mailing address
PO BOX 860123, MINNEAPOLIS, MN 55486-0112
(651) 220-6806
(651) 220-6964
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2619949
MN
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
090953000
—
MN
01
—
2048204
PK
—
Enumeration date
10/02/2006
Last updated
07/19/2018
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