Provider Demographics
NPI:1194127985
Name:COMO PHARMACY INC
Entity type:Organization
Organization Name:COMO PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PIC / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAO
Authorized Official - Middle Name:
Authorized Official - Last Name:KUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-487-0044
Mailing Address - Street 1:217 COMO AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55103-1838
Mailing Address - Country:US
Mailing Address - Phone:651-487-0044
Mailing Address - Fax:651-487-0045
Practice Address - Street 1:217 COMO AVE STE 107
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55103-1838
Practice Address - Country:US
Practice Address - Phone:651-487-0044
Practice Address - Fax:651-487-0045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-23
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2646013336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2148109OtherPK