Healthcare Provider Details

I. General information

NPI: 1013343391
Provider Name (Legal Business Name): ASTRUP DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2013
Last Update Date: 01/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 DIVISION ST S
NORTHFIELD MN
55057-2427
US

IV. Provider business mailing address

905 N MAIN ST
AUSTIN MN
55912-3357
US

V. Phone/Fax

Practice location:
  • Phone: 507-645-4455
  • Fax: 507-645-6912
Mailing address:
  • Phone: 507-433-7447
  • Fax: 507-433-1632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number264429
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DAVID BROOKS
Title or Position: DISTRICT PHARMACY MANAGER
Credential:
Phone: 612-618-6340