Organization
OUR LADY OF PEACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY THORNE (CEO)
(651) 789-5031
Entity
Organization
Contact information
Practice address
2076 SAINT ANTHONY AVE, SAINT PAUL, MN 55104-4543
(651) 789-5031
Mailing address
2076 SAINT ANTHONY AVE, SAINT PAUL, MN 55104-4543
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200706
PHARMACY LICENSE
MN
Enumeration date
01/13/2023
Last updated
01/13/2023
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