Organization
SNYDERS DRUG
Active
Other names
SNYDER DRUG EMPORIUM
Organization subpart
No
Provider details
NPI number
Authorized official
JODI RISTAU (DIRECTOR)
(952) 936-2404
Entity
Organization
Contact information
Practice address
5101 GATEWAY ST SE, PRIOR LAKE, MN 55372-2049
(952) 447-6075
(952) 447-6071
Mailing address
14525 HIGHWAY 7, MINNETONKA, MN 55345-3734
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
2618173
MN
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2417485
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
5657580 00
—
MN
05
—
565758000
—
MN
Enumeration date
10/03/2006
Last updated
08/07/2008
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