Organization
LARSON PHCY INC
Active
Other names
KINSMOR DRUG INC
Organization subpart
No
Provider details
NPI number
Authorized official
MARK LARSON (PRES)
(612) 866-8405
Entity
Organization
Contact information
Practice address
6544 PENN AVE S, RICHFIELD, MN 55423-1143
(612) 866-8405
Mailing address
6544 PENN AVE S, RICHFIELD, MN 55423-1143
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2607595
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2407698
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
04/25/2007
Last updated
09/12/2007
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