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Organization

BAMA INC

Active
Other names
CLARKS REXALL DRUG INC
Organization subpart
No

Provider details

NPI number
Authorized official
BARRY JUNGWIRTH (OWNER)
(320) 842-3221
Entity
Organization

Contact information

Practice address
1214 ATLANTIC AVE, BENSON, MN 56215-1243
(320) 842-3221
(320) 843-9974
Mailing address
1214 ATLANTIC AVE, BENSON, MN 56215-1243
(320) 842-3221
(320) 843-9974

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
205959
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2403614
NCPDP PROVIDER IDENTIFICATION NUMBER
05
MN142757100
MN
Enumeration date
08/10/2006
Last updated
08/31/2010
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