Organization
M AND J LOKENSGARD INC
Active
Other names
CRYSTAL DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL LOKENSGARD RPH (MANAGER PHARMACIST AND OWNER)
(507) 726-2727
Entity
Organization
Contact information
Practice address
142 S MAIN STREET, LAKE CRYSTAL, MN 56055
(507) 726-2727
(507) 726-6179
Mailing address
PO BOX 30, LAKE CRYSTAL, MN 56055-0030
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2602189
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2405733
OTHER ID NUMBER
—
Enumeration date
04/19/2007
Last updated
09/12/2007
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