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General NPI Number Information
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NPI Number | 1265453237
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Entity Type | Organization
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Legal Business Name | CARLSON DRUG INC
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 147 2ND ST NW
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City | ORTONVILLE
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State | MN
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Zip | 56278-1408
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Country | US
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Telephone | 320-839-6102
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Fax | 320-839-3985
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Provider Business Mailing Address
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Address Line | 147 2ND ST NW
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City | ORTONVILLE
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State | MN
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Zip | 56278-1408
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Country | US
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Telephone | 320-839-6102
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Fax | 320-839-3985
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Authorized Official
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Title or Position | PHCY OWNER
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Name | MICHAEL CARLSON
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Credential |
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Telephone | 320-839-6102
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 262145
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License Number State | MN
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