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
Update your record
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