Healthcare Provider Details

I. General information

NPI: 1730147992
Provider Name (Legal Business Name): BARNESVILLE DRUG & HARDWARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 11/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 FRONT ST S
BARNESVILLE MN
56514
US

IV. Provider business mailing address

117 FRONT ST S BOX 542
BARNESVILLE MN
56514
US

V. Phone/Fax

Practice location:
  • Phone: 218-354-2131
  • Fax: 218-354-2352
Mailing address:
  • Phone: 218-354-2131
  • Fax: 218-354-2352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number265010
License Number StateMN

VIII. Authorized Official

Name: MICHELLE HOPPE
Title or Position: OWNER/PHARMACIST
Credential:
Phone: 218-354-2131