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MR. MARK SIMON STANG RPH

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1255755310

Individual Registrant:
MR. MARK SIMON STANG RPH
Gender: M
Sole Proprietor

Location and contact information for practice:
309 CYPRESS DR  SAINT JOSEPH, MN 56374-4683 US
Tel: 320-282-6127  Fax: --

Contact information for business:
PO BOX 333 309 CYPRESS DRIVE SAINT JOSEPH, MN 56374-0333 US
Tel: 320-282-6127  Fax: --

Registration Information:
NPI: 1255755310
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
MN116267

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
MINNESOTA BOARD OF PHARMACY116267MN01




HEALTH CARE JOBS MN - Page 1



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