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General NPI Number Information
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NPI Number | 1114344215
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Entity Type | Organization
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Legal Business Name | OMC RETAIL SERVICES LLC
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Dates
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Enumeration Date | 03/26/2014
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Last Update Date | 04/18/2017
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Provider Practice Location Address
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Address Line | 210 9TH ST SE
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City | ROCHESTER
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State | MN
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Zip | 55904-6756
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Country | US
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Telephone | 507-535-1974
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Fax | 507-281-7974
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Provider Business Mailing Address
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Address Line | 210 9TH ST SE
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City | ROCHESTER
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State | MN
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Zip | 55904-6756
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Country | US
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Telephone | 507-535-1974
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Fax | 507-281-7974
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | CHRISTOPHER DORNACK
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Credential |
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Telephone | 507-292-7255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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