Provider Demographics
NPI:1265059075
Name:ROLSETH DRUG CO
Entity type:Organization
Organization Name:ROLSETH DRUG CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HAAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:651-464-2114
Mailing Address - Street 1:30699 LINCOLN RD
Mailing Address - Street 2:
Mailing Address - City:LINDSTROM
Mailing Address - State:MN
Mailing Address - Zip Code:55045-8083
Mailing Address - Country:US
Mailing Address - Phone:651-257-4074
Mailing Address - Fax:651-257-0919
Practice Address - Street 1:30699 LINCOLN RD
Practice Address - Street 2:
Practice Address - City:LINDSTROM
Practice Address - State:MN
Practice Address - Zip Code:55045-8083
Practice Address - Country:US
Practice Address - Phone:651-257-4074
Practice Address - Fax:651-257-0919
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROLSETH DRUG CO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy