Organization
SLAYTON DRUG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY HAFNER (PHARMACIST)
(507) 836-6342
Entity
Organization
Contact information
Practice address
2622 BROADWAY AVE, SLAYTON, MN 56172-1312
(507) 836-6702
(507) 836-8753
Mailing address
PO BOX 87, SLAYTON, MN 56172-0087
(507) 836-6702
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
2006633
MN
3336C0003X
Community/Retail Pharmacy
Primary
200663
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2407989
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/18/2006
Last updated
02/08/2008
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