Active NPI
Snyders Drug
Doing business as Snyder Drug Emporium
- Community/Retail Pharmacy
- Plymouth, MN
National Provider Identifier
1053405456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- SNYDERS DRUG
- Doing business as
- Snyder Drug Emporium
- Practice address
- 4132 Lancaster LN N
Plymouth, MN 55441-1707 - Phone
- (763) 559-1704
- Fax
- (763) 519-1357
- NPI assigned
- Oct 3, 2006
- Last updated
- Aug 6, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jodi Ristau
- Title
- Director
- Phone
- (952) 936-2404
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 2618157 | MN | |
| Community/Retail Pharmacy | 3336C0003X | NU | Primary |
Addresses
Primary practice location
4132 Lancaster LN N
Plymouth, MN 55441-1707
Mailing address
14525 Highway 7
Minnetonka, MN 55345-3734
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9105620 00 | Medicaid | MN | |
| 2413982 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| 910562000 | Medicaid | MN |
Other names 1
- SNYDER DRUG EMPORIUM
National Provider Directory
National Provider Directory- Tax ID family
- Snyder Drug Emporium
Other organizations with this tax ID 42
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Retail Pharmacy
- Minneapolis, MN
- NPI 1689725665
-
- Community/Retail Pharmacy
- Chaska, MN
- NPI 1104978451
Locations
4132 Lancaster Ln N
Plymouth, MN 55441
Phone (763) 559-1704
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1217980800000",
"number": "1053405456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14525 HIGHWAY 7",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553453734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4132 LANCASTER LN N",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554411707",
"telephone_number": "763-559-1704",
"fax_number": "763-519-1357"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SNYDERS DRUG",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-03",
"last_updated": "2008-08-06",
"status": "A",
"authorized_official_last_name": "RISTAU",
"authorized_official_first_name": "JODI",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "952-936-2404"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "MN",
"license": "2618157",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9105620 00",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "2413982",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "910562000",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "SNYDER DRUG EMPORIUM",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.