Healthcare Provider Details

I. General information

NPI: 1841375771
Provider Name (Legal Business Name): LUND FOOD HOLDINGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 07/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12880 ELM CREEK BLVD N
MAPLE GROVE MN
55369-7052
US

IV. Provider business mailing address

3948 W 50TH ST SUITE B-102
EDINA MN
55424-1210
US

V. Phone/Fax

Practice location:
  • Phone: 763-420-3005
  • Fax: 763-420-8624
Mailing address:
  • Phone: 877-540-4748
  • Fax: 801-716-4872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number262987
License Number StateMN

VIII. Authorized Official

Name: JODI ROBINSON
Title or Position: SR. MANAGER, PHARMACY OPS
Credential: CPHT
Phone: 952-915-3736