Provider Demographics
NPI:1922245398
Name:ST CROIX DRUG COMPANY
Entity Type:Organization
Organization Name:ST CROIX DRUG COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHEEHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-920-0460
Mailing Address - Street 1:4820 PARK GLEN RD
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-5702
Mailing Address - Country:US
Mailing Address - Phone:952-920-0460
Mailing Address - Fax:952-920-0480
Practice Address - Street 1:4820 PARK GLEN RD
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-5702
Practice Address - Country:US
Practice Address - Phone:952-920-0460
Practice Address - Fax:952-920-0480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-07
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8783612332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN82-00474OtherMEDICA