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General NPI Number Information
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NPI Number | 1912148206
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Entity Type | Organization
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Legal Business Name | MCBE COMPANY
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Dates
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Enumeration Date | 03/16/2009
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Last Update Date | 06/22/2012
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Provider Practice Location Address
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Address Line | 220 CENTERTOWN PLAZA
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City | STEWARTVILLE
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State | MN
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Zip | 55976
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Country | US
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Telephone | 507-533-6883
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Fax | 507-533-4076
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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 | 507-289-1666
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Fax | 507-536-4428
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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 | 263326
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License Number State | MN
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