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Organization

MARKETPLACE PHARMACY LLC

Active
Other names
Marketplace Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES ROE (OWNER/PHARMACIST IN CHARGE)
(507) 381-4794
Entity
Organization

Contact information

Practice address
5262 KYLER AVE NE STE 112, ALBERTVILLE, MN 55301-4706
(763) 497-2846
(763) 497-0597
Mailing address
5262 KYLER AVE NE, SUITE 112, ALBERTVILLE, MN 55301-4705
(763) 497-2846
(763) 497-0597

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
264143
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2130454
PK
05
906653200
MN
Enumeration date
06/07/2011
Last updated
10/13/2014
About Stedi
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  • EDI platform