Nicollet Pharmacy LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

NICOLLET PHARMACY LLC

Practice address

2805 Nicollet Ave
Minneapolis, MN 55408-2329

Phone

(612) 345-7619

NPI assigned

Aug 3, 2026

Organization subpart

No

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

Authorized official

Name

Deeq Mohammed, PHARM D

Title

RPH-Pic

Phone

(612) 345-7619

Specialties & licenses 1

Addresses

Tax ID family

Nicollet Pharmacy LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Nicollet Pharmacy LLC

  • Community/Retail Pharmacy
  • Minneapolis, MN
  • NPI 1285383190
  NPD tax ID

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

{
    "created_epoch": "1785715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785715200000",
    "number": "1083537542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 NICOLLET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082329",
            "telephone_number": "612-345-7619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 NICOLLET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082329",
            "telephone_number": "612-345-7619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLLET PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-03",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-02",
        "status": "A",
        "authorized_official_last_name": "MOHAMMED",
        "authorized_official_first_name": "DEEQ",
        "authorized_official_title_or_position": "RPH-PIC",
        "authorized_official_telephone_number": "612-345-7619",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicollet 38TH St Dental
• Nicollet Avenue Dental, PLLC
• Nicollet Chiropractic Center
• Nicollet Dental
• Nicollet Mall Dental Arts PLLC
• Nicollet Pharmacy LLC
• Nicollet Senior Center Inc
• Nicollet Vision Care Optometrists P.a.
• Nicollet Vision Care Optometrists P.a.
• John J Nicotra, MD

• Long Term Care Pharmacy in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Long Term Care Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2026; 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.