Organization
FIRSTSOLUTIONS
Active
Other names
SUPERIOR HEALTH PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA MASTAW MT BA, ICP (CARE DELIVERY COORDINATOR)
(218) 740-2785
Entity
Organization
Contact information
Practice address
1010 4TH ST, TWO HARBORS, MN 55616-1200
(218) 834-7202
(218) 834-9531
Mailing address
1010 4TH ST, TWO HARBORS, MN 55616-1200
(218) 834-7202
(218) 834-9531
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
204933
MN
3336M0003X
Managed Care Organization Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2412966
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
613226000
—
MN
Enumeration date
07/14/2006
Last updated
01/12/2011
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