Provider Demographics
NPI:1750379988
Name:MORCAP, INC.
Entity type:Organization
Organization Name:MORCAP, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:507-789-5202
Mailing Address - Street 1:103 RED WING AVE
Mailing Address - Street 2:P.O. BOX 32
Mailing Address - City:KENYON
Mailing Address - State:MN
Mailing Address - Zip Code:55946-1327
Mailing Address - Country:US
Mailing Address - Phone:507-789-5202
Mailing Address - Fax:507-789-5743
Practice Address - Street 1:103 RED WING AVE
Practice Address - Street 2:
Practice Address - City:KENYON
Practice Address - State:MN
Practice Address - Zip Code:55946-1327
Practice Address - Country:US
Practice Address - Phone:507-789-5202
Practice Address - Fax:507-789-5743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2603175333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0257940001Medicare ID - Type Unspecified