Organization
CHANHASSEN CENTER DRUG
Active
Other names
CHANHASSEN CENTER DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE ANDERSON (RPH)
(952) 949-1002
Entity
Organization
Contact information
Practice address
111 HUNDERTMARK RD STE 100, CHASKA, MN 55318-1194
(952) 949-1002
(952) 949-0233
Mailing address
111 HUNDERTMARK RD, SUITE 100, CHASKA, MN 55318-4551
(952) 949-1002
(952) 949-0233
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2625522
MN
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
099560600
—
MN
01
—
2046933
PK
—
Enumeration date
08/31/2006
Last updated
01/22/2016
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