Erickson Drug Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

262902 Issued in MN

Legal business name

ERICKSON DRUG INC

Doing business as

Blomberg Pharmacy

Practice address

1583 Hamline Ave N
Saint Paul, MN 55108-2139

Phone

(651) 646-9645

Fax

(651) 632-2164

NPI assigned

Dec 11, 2006

Organization subpart

No

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

Authorized official

Name

Robert Koziol, PHARM D

Title

Owner and Sec Treas

Phone

(952) 469-2964

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• BLOMBERG PHARMACY Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christiane Blank Knaus, PHARMD RPH

  • Pharmacist
  • Falcon Heights, MN
  • NPI 1316956527
  NPD (past)

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341446400000",
    "number": "1053471292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1583 HAMLINE AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551082139",
            "telephone_number": "651-646-9645",
            "fax_number": "651-632-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1583 HAMLINE AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551082139",
            "telephone_number": "651-646-9645",
            "fax_number": "651-632-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERICKSON DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2012-07-05",
        "status": "A",
        "authorized_official_last_name": "KOZIOL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER AND SEC TREAS",
        "authorized_official_telephone_number": "952-469-2964",
        "authorized_official_credential": "PHARM D"
    },
    "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": "262902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2416368",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "327108000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BLOMBERG PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Annie Erdahl, LICSW
• Sara Beth Erdman, L.AC.
• Linden Erdmann, C-SLPA
• Sheryl Renee Erenberg
• Janet D Ericksmoen
• Anna-Lisa Erickson, CRNA
• Christopher M Erickson, CRNA
• Dana Lynn Erickson, LPCC, LADC
• Dina Abedaziz Erickson, MSN, APRN, PMHNP-BC
• Donald Merle Erickson, D.D.S.

• Community/Retail Pharmacy in Saint Paul, MN
• Providers in Saint Paul, 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 Jul 5, 2012; 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.