Organization
MACKENTHUN BECK PHARMACY, INC
Active
Other names
Beck Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JESSA THEIS (OWNER)
(952) 442-5765
Entity
Organization
Contact information
Practice address
851 MARKETPLACE DR, WACONIA, MN 55387-1548
(952) 442-4407
(952) 442-5787
Mailing address
851 MARKETPLACE DR, WACONIA, MN 55387-1548
(952) 442-4407
(952) 442-5787
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
262255-4
MN
3336C0003X
Community/Retail Pharmacy
Primary
262255-4
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
588678000
—
MN
Enumeration date
02/28/2007
Last updated
04/22/2009
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