Healthcare Provider Details

I. General information

NPI: 1245368448
Provider Name (Legal Business Name): SEIP DRUG LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 11/28/2022
Certification Date: 11/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 E MAIN ST SUITE D
FRAZEE MN
56544
US

IV. Provider business mailing address

PO BOX 248
FRAZEE MN
56544-0248
US

V. Phone/Fax

Practice location:
  • Phone: 218-334-3070
  • Fax: 218-334-4664
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number262970
License Number StateMN

VIII. Authorized Official

Name: NATHAN SEIP
Title or Position: CHIEF MNGR
Credential:
Phone: 218-640-2722