Judean Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

260515 Issued in MN

Legal business name

JUDEAN INC

Doing business as

Lichty Drugs

Practice address

601 1St Ave
Westbrook, MN 56183

Phone

(507) 274-6114

Fax

(507) 274-5688

NPI assigned

Sep 21, 2006

Last updated

Mar 20, 2009By 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

Dean Lichty

Title

President

Phone

(507) 274-6114

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• LICHTY DRUGS Doing business as

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237507200000",
    "number": "1073611075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 127",
            "city": "WESTBROOK",
            "state": "MN",
            "postal_code": "561830127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 1ST AVE",
            "city": "WESTBROOK",
            "state": "MN",
            "postal_code": "56183",
            "telephone_number": "507-274-6114",
            "fax_number": "507-274-5688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUDEAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2009-03-20",
        "status": "A",
        "authorized_official_last_name": "LICHTY",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "507-274-6114"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "260515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2409173",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "932757600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LICHTY DRUGS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie Rae Clausen-Swenson, MA, LPCC, LMFT
• Cindy Jo Getting, RPH
• Ashley Green
• Ashley Sabin Heibel, FNP-C
• Kelly J Hoffman, NP
• Vivien H Jutsum, APRN
• Carolyn Kirchner, RN
• Andrew Jon Kopperud, MD
• Victoria Radke
• Alyssa Reinsma, COTA/L

• Community/Retail Pharmacy in Westbrook, MN
• Providers in Westbrook, 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 Mar 20, 2009; 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.