LUND FOOD HOLDINGS, INC.

Provider Demographics

• NPI: 1639335441
• Name: LUND FOOD HOLDINGS, INC.
• Entity Type: Organization
• Organization Name: LUND FOOD HOLDINGS, INC.
• Authorized Official - Title/Position: CFO
• Authorized Official - First Name: FRED
• Authorized Official - Last Name: MILLER
• Authorized Official - Phone: 952-915-3701
• Mailing Address - Street 1: 4100 W 50TH ST
• Mailing Address - City: EDINA
• Mailing Address - State: MN
• Mailing Address - Zip Code: 55424-1200
• Mailing Address - Country: US
• Mailing Address - Phone: 952-915-3737
• Mailing Address - Fax: 952-915-3789
• Practice Address - Street 1: 4100 W 50TH ST
• Practice Address - City: EDINA
• Practice Address - State: MN
• Practice Address - Zip Code: 55424-1200
• Practice Address - Country: US
• Practice Address - Phone: 952-915-3737
• Practice Address - Fax: 952-915-3789
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2008-07-31
• Last Update Date: 2009-04-01

Provider Licenses

State	License ID	Taxonomies
MN	3748654	183500000X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	183500000X	Pharmacy Service Providers	Pharmacist		Group - Single Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
MN	165472000	Medicaid
MN	177135000	Medicaid
MN	207623000	Medicaid
MN	634995000	Medicaid
MN	731407000	Medicaid
MN	027137000	Medicaid
MN	394407000	Medicaid
MN	726623000	Medicaid
MN	985460000	Medicaid
MN	461490000	Medicaid
MN	474652100	Medicaid
MN	596472000	Medicaid
MN	141967000	Medicaid
MN	718623000	Medicaid
MN	614900000	Medicaid
MN	884638200	Medicaid
MN	461490000	Medicaid
MN	726623000	Medicaid
MN	5946720007	Medicare NSC
MN	5991170001	Medicare NSC
MN	141967000	Medicaid
MN	5537710002	Medicare NSC
MN	165472000	Medicaid
MN	207623000	Medicaid
MN	394407000	Medicaid
MN	884638200	Medicaid
MN	731407000	Medicaid
MN	5537710001	Medicare NSC
MN	5946720004	Medicare NSC
MN	5537710008	Medicare NSC
MN	5537710005	Medicare NSC
MN	5946720002	Medicare NSC