Healthcare Provider Details

I. General information

NPI: 1932716339
Provider Name (Legal Business Name): ASTRUP DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2020
Last Update Date: 09/29/2020
Certification Date: 09/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 VALLEY GREEN SQ
LE SUEUR MN
56058-1915
US

IV. Provider business mailing address

905 N MAIN ST
AUSTIN MN
55912-3357
US

V. Phone/Fax

Practice location:
  • Phone: 507-665-3301
  • Fax:
Mailing address:
  • Phone: 507-434-7425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TINA MILLER
Title or Position: EXECUTIVE ASSISTANT
Credential:
Phone: 507-433-7447