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2008 County Road E E White Bear Lake MN 55110-7333 | |
(651) 289-4300 | |
(651) 289-4301 |
Full Name | |
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Speciality | Clinic/center |
Location | 2008 County Road E E, White Bear Lake, Minnesota |
Authorized Official Name and Position | Joseph Norman Jorgenson (PHARMACIST IN CHARGE) |
Authorized Official Contact | 6512894300 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2008 County Road E E White Bear Lake MN 55110-7333 Ph: (651) 289-4300 | 2008 County Road E E White Bear Lake MN 55110-7333 Ph: (651) 289-4300 |
NPI Number | 1639474612 |
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Provider Enumeration Date | 01/21/2011 |
Last Update Date | 05/07/2011 |
Identifier | Type | State | Issuer |
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1639474612 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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