Individual provider Active NPI

Molly Jo Ekstrand, R.PH.

  • Pharmacist
  • St Louis Park, MN
National Provider Identifier
1093712390
Registry record updated Jul 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
116275-6 Issued in MN
Practice address
6600 Excelsior Blvd Ste 151
St Louis Park, MN 55426-4706
Phone
(952) 993-2087
Fax
(952) 993-1334
NPI assigned
Jun 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 116275-6 MN Primary

Addresses

Primary practice location

6600 Excelsior Blvd Ste 151
St Louis Park, MN 55426-4706

Mailing address

6600 Excelsior Blvd Ste 151
St Louis Park, MN 55426-4706
Phone (952) 993-2087

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
116275-6MNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405296000000",
    "number": "1093712390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 EXCELSIOR BLVD STE 151",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264706",
            "telephone_number": "952-993-2087",
            "fax_number": "952-993-1334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 EXCELSIOR BLVD STE 151",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264706",
            "telephone_number": "952-993-2087",
            "fax_number": "952-993-1334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKSTRAND",
        "first_name": "MOLLY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2014-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "116275-6",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2014; 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.