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NPI Code Detail

MEDICARE: LAB DRUGS & MEDICAL -TRANS-SUPPLIES LLC

MEDICARE: LAB DRUGS & MEDICAL -TRANS-SUPPLIES LLC
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
1333600000XPharmacy
2332B00000XDurable Medical Equipment & Medical Supplies263458MN
33336C0003XCommunity/Retail Pharmacy263458MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2730000092OTHERMASS IMMUIZATION PTAN
32429959OTHERNCPDP PROVIDER IDENTIFICATION NUMBER
4263458OTHERMNPHARMACY LICENSE

General Provider Information

NPI Number : 1801126214
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAB DRUGS & MEDICAL -TRANS-SUPPLIES LLC
Provider Business Mailing Address
First Line : 8561 EDINBURGH CENTER DR
Second Line :
City : BROOKLYN PARK
State : MN
Zip : 55443-3724
Country : US
Telephone Number : 763-777-5995
Fax Number : 763-777-5974
Provider Business Practice Location Address
First Line : 8561 EDINBURGH CENTER DR
Second Line :
City : BROOKLYN PARK
State : MN
Zip : 55443-3724
Country : US
Telephone Number : 763-777-5995
Fax Number : 763-777-5974
Authorized Official
Title or Position : OWNER/PHARMACIST-IN-CHARGE
Name : LOLA ISHOLA
Credential :
Telephone Number : 763-777-5995
Provider Enumeration Date : 01/06/2010
Last Update Date : 06/03/2015

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Directions to “LAB DRUGS & MEDICAL -TRANS-SUPPLIES LLC ” Practice Location

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