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General NPI Number Information
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NPI Number | 1700813086
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Entity Type | Organization
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Legal Business Name | B & C OF CROOKSTON INC
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 211 N MAIN ST
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City | CROOKSTON
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State | MN
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Zip | 56716-1736
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Country | US
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Telephone | 218-281-7045
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Fax | 218-281-1708
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Provider Business Mailing Address
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Address Line | 211 N MAIN ST
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City | CROOKSTON
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State | MN
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Zip | 56716-1736
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Country | US
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Telephone | 218-281-7045
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Fax | 218-281-1708
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Authorized Official
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Title or Position | OWNER
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Name | MR. ROBERT DALE ROPPEL
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Credential | R.PH.
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Telephone | 218-281-7045
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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 | 262293-6
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License Number State | MN
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