Healthcare Provider Details

I. General information

NPI: 1730696923
Provider Name (Legal Business Name): THRIFTY DRUG STORES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2018
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 S 1ST ST
OLIVIA MN
56277-2442
US

IV. Provider business mailing address

6701 EVENSTAD DR N STE 100
MAPLE GROVE MN
55369-6013
US

V. Phone/Fax

Practice location:
  • Phone: 320-523-2110
  • Fax: 320-523-2113
Mailing address:
  • Phone: 763-513-4300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPENDING
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ANNE BRADER
Title or Position: CFO
Credential:
Phone: 763-513-4300