Provider Demographics
NPI:1114286598
Name:ASTRUP DRUG INC
Entity Type:Organization
Organization Name:ASTRUP DRUG INC
Other - Org Name:STERLING #27
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DISTRICT PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-618-6340
Mailing Address - Street 1:ASTRUP DRUG, INC.
Mailing Address - Street 2:905 NORTH MAIN ST.
Mailing Address - City:AUSTIN
Mailing Address - State:MN
Mailing Address - Zip Code:55912
Mailing Address - Country:US
Mailing Address - Phone:507-434-7428
Mailing Address - Fax:507-433-1632
Practice Address - Street 1:44 MAIN AVE N
Practice Address - Street 2:
Practice Address - City:HARMONY
Practice Address - State:MN
Practice Address - Zip Code:55939-8888
Practice Address - Country:US
Practice Address - Phone:507-886-2322
Practice Address - Fax:507-886-2905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-07
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2644303336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2134944OtherPK
0489460023Medicare NSC