Organization
MAIN STREET PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDALL ALVIN HOHBEIN RPH (OWNER)
(763) 493-5242
Entity
Organization
Contact information
Practice address
24 3RD STREET NE, OSSEO, MN 55369
(763) 493-5242
(763) 493-2621
Mailing address
24 3RD STREET NE, OSSEO, MN 55369
(763) 493-5242
(763) 493-2621
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
2605322
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2418526
NABP
—
01
—
2605322
STATE BOARD OF PHARMACY
MN
05
—
484360600
—
MN
Enumeration date
11/22/2006
Last updated
04/10/2013
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