Organization
LIEBE DRUG INC
Active
Other names
LIEBE DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIE TRITZ RPH (RPH)
(320) 748-7112
Entity
Organization
Contact information
Practice address
318 STUDDART AVE, GRACEVILLE, MN 56240-7735
(320) 748-7112
(320) 748-7228
Mailing address
PO BOX 218, GRACEVILLE, MN 56240-0218
(320) 748-7112
(320) 748-7228
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
261630
MN
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2422967
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
616519200
—
MN
Enumeration date
06/08/2005
Last updated
01/18/2012
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