Healthcare Provider Details

I. General information

NPI: 1255841193
Provider Name (Legal Business Name): ASTRUP DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2017
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 NORTHLAND DR STE 204
MENDOTA HEIGHTS MN
55120-1013
US

IV. Provider business mailing address

1408 NORTHLAND DR STE 204
MENDOTA HEIGHTS MN
55120-1013
US

V. Phone/Fax

Practice location:
  • Phone: 651-412-5939
  • Fax: 651-412-5990
Mailing address:
  • Phone: 888-341-1542
  • Fax: 507-697-0082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number265420
License Number StateMN

VIII. Authorized Official

Name: TINA MILLER
Title or Position: SENIOR CONTRACTING & LICENSING SPEC
Credential:
Phone: 507-433-7447