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General NPI Number Information
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NPI Number | 1689028854
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Entity Type | Organization
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Legal Business Name | SLTN PHARMACY SERVICES, LTD
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Dates
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Enumeration Date | 04/14/2016
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Last Update Date | 04/14/2016
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Provider Practice Location Address
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Address Line | 115 N ST PAUL AVE
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City | FULDA
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State | MN
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Zip | 56131-1156
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Country | US
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Telephone | 507-425-3166
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Fax | 507-253-3168
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Provider Business Mailing Address
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Address Line | 2010 JUNIPER AVE
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City | SLAYTON
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State | MN
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Zip | 56172-1017
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Country | US
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Telephone | 507-873-2075
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Fax | 507-873-2076
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHELSEY CARLSON
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Credential | PHARMD
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Telephone | 507-873-2075
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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 | 264015
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License Number State | MN
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