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General NPI Number Information
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NPI Number | 1073895041
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Entity Type | Organization
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Legal Business Name | THRIFTY DRUG STORES INC
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Dates
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Enumeration Date | 09/15/2011
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 310 LAKE ST NE
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City | WARROAD
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State | MN
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Zip | 56763-2303
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Country | US
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Telephone | 218-386-2050
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Fax | 218-386-2054
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Provider Business Mailing Address
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Address Line | 6701 EVENSTAD DR N STE 100
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City | MAPLE GROVE
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State | MN
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Zip | 55369-6013
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Country | US
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Telephone | 763-513-4300
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | TIMOTHY WEIPPERT
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Credential |
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Telephone | 763-585-3507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 263766
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License Number State | MN
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