Organization
MERWIN BROADWAY PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MILLAR (PHARMACIST)
(612) 522-3608
Entity
Organization
Contact information
Practice address
700 W BROADWAY AVE, MINNEAPOLIS, MN 55411-2612
(612) 522-3608
(612) 522-0091
Mailing address
700 W BROADWAY AVE, MINNEAPOLIS, MN 55411-2612
(612) 522-3608
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
2624523
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2402650
OTHER ID NUMBER
—
05
—
744442700
—
MN
Enumeration date
08/10/2006
Last updated
12/31/2009
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