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General NPI Number Information
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NPI Number | 1194127985
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Entity Type | Organization
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Legal Business Name | COMO PHARMACY INC
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Dates
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Enumeration Date | 09/23/2014
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Last Update Date | 06/01/2016
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Provider Practice Location Address
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Address Line | 217 COMO AVE STE 107
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City | SAINT PAUL
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State | MN
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Zip | 55103-1838
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Country | US
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Telephone | 651-487-0044
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Fax | 651-487-0045
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Provider Business Mailing Address
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Address Line | 217 COMO AVE SUITE 107
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City | SAINT PAUL
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State | MN
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Zip | 55103-1838
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Country | US
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Telephone | 651-487-0044
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Fax | 651-487-0045
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Authorized Official
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Title or Position | PIC / OWNER
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Name | PAO KUE
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Credential |
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Telephone | 651-487-0044
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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 | 264601
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License Number State | MN
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