Provider Demographics
NPI:1295926053
Name:ASTRUP DRUG INC
Entity type:Organization
Organization Name:ASTRUP DRUG INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:J
Authorized Official - Last Name:GALLAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:507-434-7428
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 1:905 N MAIN ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:MN
Practice Address - Zip Code:55912-3357
Practice Address - Country:US
Practice Address - Phone:507-433-7447
Practice Address - Fax:507-433-1632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2428123OtherNCPDP PROVIDER IDENTIFICATION NUMBER