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General NPI Number Information
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NPI Number | 1922146836
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Entity Type | Organization
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Legal Business Name | MERTENS DRUG INC
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 204 JEFFERSON ST N
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City | WADENA
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State | MN
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Zip | 56482-1371
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Country | US
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Telephone | 218-631-2402
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Fax | 218-631-2723
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Provider Business Mailing Address
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Address Line | 204 JEFFERSON ST N
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City | WADENA
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State | MN
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Zip | 56482-1371
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Country | US
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Telephone | 218-631-2402
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Fax | 218-631-2723
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL FRANK MERTENS
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Credential | RPH
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Telephone | 218-631-2402
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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 | 2606253
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License Number State | MN
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