Blair Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2609386 Issued in MN

Legal business name

BLAIR INC

Doing business as

Medicine Shoppe

Practice address

406 Belgrade Ave
North Mankato, MN 56003-3809

Phone

(507) 387-6521

Fax

(507) 387-7982

NPI assigned

Feb 21, 2007

Last updated

Oct 4, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dena Ferman

Title

Third Party Plan Coordinator

Phone

(314) 993-6000

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• MEDICINE SHOPPE Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191456000000",
    "number": "1033254669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 BELGRADE AVE",
            "city": "NORTH MANKATO",
            "state": "MN",
            "postal_code": "560033809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 BELGRADE AVE",
            "city": "NORTH MANKATO",
            "state": "MN",
            "postal_code": "560033809",
            "telephone_number": "507-387-6521",
            "fax_number": "507-387-7982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAIR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-10-04",
        "status": "A",
        "authorized_official_last_name": "FERMAN",
        "authorized_official_first_name": "DENA",
        "authorized_official_title_or_position": "THIRD PARTY PLAN COORDINATOR",
        "authorized_official_telephone_number": "314-993-6000"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "2609386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "2420331",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2420331",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICINE SHOPPE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daniel Brian Backman
• Sierra Bales, LADC
• Kenneth J Bentson, P.A.
• Sara T Beske, NP
• Kelsey Bigbee, RD
• Nicole Ann Blake, RDH/DT
• Matt Blanshan, CPRS
• Brandon Boeck
• Hannah Joan Bradley, AUD
• Ashley Anne Bratsch, MS, CCC-SLP

• Community/Retail Pharmacy in North Mankato, MN
• Providers in North Mankato, MN by specialty
• Community/Retail Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.