MEDICARE: ASTRUP DRUG INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	3336L0003X	Long Term Care Pharmacy	265420	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2172151	OTHER		PK

General Provider Information

NPI Number	:	1255841193
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASTRUP DRUG INC

Provider Business Mailing Address
First Line	:	1408 NORTHLAND DR STE 204
Second Line	:
City	:	MENDOTA HEIGHTS
State	:	MN
Zip	:	55120-1013
Country	:	US
Telephone Number	:	888-341-1542
Fax Number	:	507-697-0082

Provider Business Practice Location Address
First Line	:	1408 NORTHLAND DR STE 204
Second Line	:
City	:	MENDOTA HEIGHTS
State	:	MN
Zip	:	55120-1013
Country	:	US
Telephone Number	:	651-412-5939
Fax Number	:	651-412-5990

Authorized Official
Title or Position	:	SENIOR CONTRACTING & LICENSING SPEC
Name	:	TINA MILLER
Credential	:
Telephone Number	:	507-433-7447

Provider Enumeration Date	:	10/05/2017
Last Update Date	:	11/11/2025

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