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General NPI Number Information
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NPI Number | 1134231590
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Entity Type | Organization
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Legal Business Name | AITKIN PHARMACY SERVICES, LLC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 07/31/2012
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Provider Practice Location Address
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Address Line | 25 2ND STREET, NE
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City | AITKIN
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State | MN
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Zip | 56431
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Country | US
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Telephone | 218-927-3754
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Fax | 218-927-6349
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Provider Business Mailing Address
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Address Line | 901 4TH STREET SUITE 170
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City | HUDSON
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State | WI
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Zip | 54016
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Country | US
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Telephone | 715-808-0873
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Fax | 715-953-4201
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Authorized Official
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Title or Position | CEO
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Name | MR. MATTHEW J HUTERA
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Credential |
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Telephone | 715-808-0873
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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 | 263647
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License Number State | MN
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Taxonomy #2
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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 #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 263647
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License Number State | MN
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