Organization
STATE OF MINNESOTA-MINNESOTA MANAGEMENT AND BUDGET
Active
Parent organization
STATE OF MINNESOTA-MINNESOTA MANAGEMENT AND BUDGET
Other names
Minnesota Veterans Home Pharmacy, Minnesota Veterans Home - Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF MINNESOTA-MINNESOTA MANAGEMENT AND BUDGET
Authorized official
MARY ELIZABETH JOHNSON (CENTRAL PHARMACY, PHARMACIST SENIOR)
(612) 548-5962
Entity
Organization
Contact information
Practice address
5101 MINNEHAHA AVE, MINNEAPOLIS, MN 55417-1647
(612) 548-5930
(612) 548-5935
Mailing address
5101 MINNEHAHA AVE BLDG 10, MINNEAPOLIS, MN 55417-1647
(612) 548-5930
(612) 548-5935
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
201261
MN
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2413499
NCPDP
—
Enumeration date
10/19/2009
Last updated
03/19/2019
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