Organization
MCBE COMPANY
Active
Other names
Weber & Judd - Pine Island
Organization subpart
No
Provider details
NPI number
Authorized official
WADE HANSON (MANAGER)
(507) 289-1666
Entity
Organization
Contact information
Practice address
111 CTY ROAD 11, PINE ISLAND, MN 55963-9756
(507) 356-8343
(507) 356-4334
Mailing address
PO BOX 5877, ROCHESTER, MN 55903-5877
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
260813
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871645879
—
MN
01
—
2419679
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
307360200
—
MN
Enumeration date
01/18/2007
Last updated
06/22/2012
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