Provider Demographics
NPI:1013343391
Name:ASTRUP DRUG INC
Entity Type:Organization
Organization Name:ASTRUP DRUG INC
Other - Org Name:STERLING
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 1:905 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:507-433-1632
Practice Address - Street 1:700 DIVISION ST S
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55057-2427
Practice Address - Country:US
Practice Address - Phone:507-645-4455
Practice Address - Fax:507-645-6912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-19
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2644293336C0003X
3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1013343391Medicaid
2142159OtherPK
0489460026Medicare NSC