Provider Demographics
NPI:1114409257
Name:ASTRUP DRUG, INC.
Entity Type:Organization
Organization Name:ASTRUP DRUG, INC.
Other - Org Name:CORNER DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-434-7425
Mailing Address - Street 1:905 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:MN
Mailing Address - Zip Code:55912-3357
Mailing Address - Country:US
Mailing Address - Phone:507-433-7447
Mailing Address - Fax:
Practice Address - Street 1:204 VALLEY GREEN SQ
Practice Address - Street 2:
Practice Address - City:LE SUEUR
Practice Address - State:MN
Practice Address - Zip Code:56058-1915
Practice Address - Country:US
Practice Address - Phone:507-665-3301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-05
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty