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General NPI Number Information
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NPI Number | 1619976495
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Entity Type | Organization
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Legal Business Name | LIEBE DRUG INC
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Dates
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Enumeration Date | 07/14/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 145 N MILES ST
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City | APPLETON
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State | MN
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Zip | 56208-1316
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Country | US
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Telephone | 320-289-2593
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Fax |
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Provider Business Mailing Address
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Address Line | 145 N MILES ST
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City | APPLETON
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State | MN
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Zip | 56208-1316
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Country | US
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Telephone | 320-289-2593
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Fax |
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Authorized Official
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Title or Position | PHARMACIST/MANAGER
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Name | MR. JOHN MICHAEL PFAFF
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Credential | RPH
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Telephone | 320-289-2593
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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 | 2613589
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License Number State | MN
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