Organization
COUNTRY MANOR CAMPUS LLC
Active
Parent organization
THE FOUNDATION FOR HEALTH CARE CONTINUUMS
Other names
Country Store and Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE FOUNDATION FOR HEALTH CARE CONTINUUMS
Authorized official
KEVIN HARGUTH (C.F.O.)
(320) 258-8983
Entity
Organization
Contact information
Practice address
520, 1ST. ST. NE, SARTELL, MN 56377-1274
(320) 255-0801
Mailing address
520, 1ST. ST. NE, SARTELL, MN 56377-1274
(320) 255-0801
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
04/18/2008
Last updated
06/30/2021
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