Provider Demographics
NPI:1689028854
Name:SLTN PHARMACY SERVICES, LTD
Entity type:Organization
Organization Name:SLTN PHARMACY SERVICES, LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHELSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:507-873-2075
Mailing Address - Street 1:2010 JUNIPER AVE
Mailing Address - Street 2:
Mailing Address - City:SLAYTON
Mailing Address - State:MN
Mailing Address - Zip Code:56172-1017
Mailing Address - Country:US
Mailing Address - Phone:507-873-2075
Mailing Address - Fax:507-873-2076
Practice Address - Street 1:115 N ST PAUL AVE
Practice Address - Street 2:
Practice Address - City:FULDA
Practice Address - State:MN
Practice Address - Zip Code:56131-1156
Practice Address - Country:US
Practice Address - Phone:507-425-3166
Practice Address - Fax:507-253-3168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-14
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2640153336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2431764OtherNCPDP