Healthcare Provider Details

I. General information

NPI: 1831203827
Provider Name (Legal Business Name): CLAIR J EINEN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 09/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 S MAIN ST
LAMBERTON MN
56152-1376
US

IV. Provider business mailing address

210 S MAIN ST
LAMBERTON MN
56152-1376
US

V. Phone/Fax

Practice location:
  • Phone: 507-752-7826
  • Fax: 507-752-7826
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number2053673
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NANCY HARNACK
Title or Position: MANAGER
Credential:
Phone: 507-752-7826