Active NPI
Daniel Fandrich
- Pharmacist
- Mankato, MN
National Provider Identifier
1003193160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 114598
- Practice address
- 1270 E Madison Ave
Mankato, MN 56001-5228 - Phone
- (507) 388-1315
- Fax
- (507) 388-6369
- NPI assigned
- Nov 3, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 114598 | MN | Primary |
Addresses
Primary practice location
1270 E Madison Ave
Mankato, MN 56001-5228
Mailing address
1270 E Madison Ave
Mankato, MN 56001-5228
Phone (507) 388-1315
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 114598 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320278400000",
"number": "1003193160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1270 E MADISON AVE",
"city": "MANKATO",
"state": "MN",
"postal_code": "560015228",
"telephone_number": "507-388-1315",
"fax_number": "507-388-6369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1270 E MADISON AVE",
"city": "MANKATO",
"state": "MN",
"postal_code": "560015228",
"telephone_number": "507-388-1315",
"fax_number": "507-388-6369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANDRICH",
"first_name": "DANIEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-03",
"last_updated": "2011-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "114598",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mankato, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.