Healthcare Provider Details

I. General information

NPI: 1629510854
Provider Name (Legal Business Name): THRIFTY DRUG STORES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2016
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2018 15TH ST NW
ROCHESTER MN
55901-0716
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 507-281-1676
  • Fax: 507-281-2953
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 TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number265196
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY WEIPPERT
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 763-585-3507