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General NPI Number Information
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NPI Number | 1790874303
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Entity Type | Organization
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Legal Business Name | WEBER & JUDD CO
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 06/20/2012
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Provider Practice Location Address
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Address Line | 1814 15TH ST NW
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City | ROCHESTER
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State | MN
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Zip | 55901-0707
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Country | US
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Telephone | 507-285-9079
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Fax | 507-289-2190
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Provider Business Mailing Address
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Address Line | PO BOX 5877
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City | ROCHESTER
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State | MN
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Zip | 55903-5877
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | WADE HANSON
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Credential |
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Telephone | 507-289-1666
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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 |
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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 | 261295
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License Number State | MN
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