Goodrich Pharmacy, INC.
Pharmacy, Clinic Pharmacy in Elk River, MN. Organization (NPI-2).
NPI number1174635171
StatusActive
Last updated in NPPESJul 6, 2023
Details
- NPI
- 1174635171
- Entity type
- Organization (NPI-2)
- Legal business name
- Goodrich Pharmacy, INC.
- Organization subpart
- No
- Enumeration date
- Aug 31, 2006
- Certification date
- Jun 29, 2023
- Last updated
- Jul 6, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0002X | Pharmacy, Clinic Pharmacy | 265080 | MN | Yes |
| 333600000X | Pharmacy | – | – | |
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – |
Other names
- Goodrich Pharmacy Elk River (Doing Business As)
Practice location
530 3rd St NwElk River, MN 55330-1445
Phone 763-441-0764 · Fax 763-587-4897
Mailing address
2621 Greenhaven Rd Ste 1Anoka, MN 55303-5566
Phone 763-441-0764 · Fax 763-587-4897
Authorized official
Stephanie Marie Davis
Owner
7634215540
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