Organization
CHILDRENS HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHESTEVIA GIBSON (OUTPATIENT PHARMCY MANAGER)
(612) 813-7290
Entity
Organization
Contact information
Practice address
2525 CHICAGO AVE S, CHILDRENS HOSPITALS AND CLINICS RETAIL PHARMACY MPLS, MINNEAPOLIS, MN 55404
(612) 813-6210
Mailing address
5901 LINCOLN DR, CBC-2-REV/PE, EDINA, MN 55436-1611
(952) 992-5691
(952) 992-6917
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
2009915
MN
Other
Enumeration date
02/15/2007
Last updated
10/31/2022
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