Organization
WARREN PHARMACY INC
Active
Other names
WARREN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SHELBY KNOTT PHARMD (PRESIDENT, SHAREHOLDER, PIC)
(218) 289-5859
Entity
Organization
Contact information
Practice address
103 W JOHNSON AVE, WARREN, MN 56762-1102
(218) 745-5481
(218) 745-5482
Mailing address
103 W JOHNSON AVE, WARREN, MN 56762-1102
(218) 745-5481
(218) 745-5482
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2045164
PK
—
05
—
418258800
—
MN
Enumeration date
07/30/2006
Last updated
07/12/2024
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