Organization
WATERTOWN PHARMACY LLC
Active
Other names
Watertown Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ROSEMARY LOUISE ROSDAHL RPH (CHIEF MANAGER)
(952) 955-2153
Entity
Organization
Contact information
Practice address
204 LEWIS AVE S, SUITE 101, WATERTOWN, MN 55388-4500
(952) 955-2153
Mailing address
204 LEWIS AVE S, SUITE 101, WATERTOWN, MN 55388-4500
(952) 955-2153
(952) 955-3067
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
261954
MN
3336C0003X
Community/Retail Pharmacy
Primary
261954
MN
3336L0003X
Long Term Care Pharmacy
261954
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720013279
—
MN
Enumeration date
07/12/2006
Last updated
04/13/2022
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