Organization
OMC RETAIL SERVICES LLC
Active
Other names
Olmsted Medical Center Northwest Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE ROACH PHARMD (PHARMACIST)
(507) 535-1974
Entity
Organization
Contact information
Practice address
5067 55TH ST NW, ROCHESTER, MN 55901-3809
(507) 535-1974
(507) 281-7685
Mailing address
5067 55TH ST NW, ROCHESTER, MN 55901-3809
(507) 535-1974
(507) 281-7685
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
264014
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811241169
—
MN
01
—
2137820
PK
—
Enumeration date
11/07/2012
Last updated
05/30/2017
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