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NPI 1407945009

NPI 1407945009 : THRIFTY DRUG STORES INC : CROOKSTON, MN

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General NPI Number Information
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    NPI Number           |    1407945009
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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     |    10/12/2006
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    Last Update Date     |    10/29/2024
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Provider Practice Location Address
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    Address Line         |    206 N MAIN ST 
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    City                 |    CROOKSTON
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    State                |    MN
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    Zip                  |    56716-1743
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    Country              |    US
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    Telephone            |    218-281-2540
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    Fax                  |    218-281-6742
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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        |    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 #2
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    Taxonomy Code        |    332B00000X
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    Taxonomy Name        |    Durable Medical Equipment & Medical Supplies
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    License Number       |    PHAR331
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    License Number State |    ND
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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       |    
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    License Number State |    
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Taxonomy #4
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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 #5
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    Taxonomy Code        |    3336C0003X
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    Taxonomy Name        |    Community/Retail Pharmacy
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    License Number       |    259983
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    License Number State |    MN
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