NPIMap

Organization Active NPI

Park Nicollet Methodist Hospital

Doing business as Methodist Hospital Pharmacy

  • Institutional Pharmacy
  • St Louis Park, MN
National Provider Identifier
1093738957
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
200304 Issued in MN
Legal business name
PARK NICOLLET METHODIST HOSPITAL
Doing business as
Methodist Hospital Pharmacy
Practice address
6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone
(952) 993-6016
Fax
(952) 993-6303
NPI assigned
Jul 25, 2006
Last updated
Aug 9, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
PARK NICOLLET PHARMACYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Authorized official

Name
Jason James Luhrs
Title
VP Finance
Phone
(952) 883-7158

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X NU
Home Infusion Therapy Pharmacy 3336H0001X NU
Institutional Pharmacy 3336I0012X 200304 MN Primary
Compounding Pharmacy 3336C0004X NU

Addresses

Primary practice location

6500 Excelsior Blvd
St Louis Park, MN 55426-4702

Mailing address

8170 33Rd Ave S
Ms 21111B
Bloomington, MN 55425-4516
Phone (952) 993-3804

Other identifiers 2

IdentifierTypeStateIssuer
897017300MedicaidMN
2045768OtherPK

Other names 1

  • METHODIST HOSPITAL PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Back and Neck Clinic12 organizations share this tax ID, including this one
Part of
Park Nicollet

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660003200000",
    "number": "1093738957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS 21111B",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "952-993-3804",
            "fax_number": "952-967-6667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 EXCELSIOR BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264702",
            "telephone_number": "952-993-6016",
            "fax_number": "952-993-6303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK NICOLLET METHODIST HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARK NICOLLET PHARMACY",
        "enumeration_date": "2006-07-25",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A",
        "authorized_official_last_name": "LUHRS",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "952-883-7158"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "MN",
            "license": "200304",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "897017300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2045768",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "METHODIST HOSPITAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "METHODIST HOSPITAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 9, 2022; 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.