Snyders Drug

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SNYDERS DRUG

Practice address

1865 W Wayzata Blvd
Long Lake, MN 55356-9671

Phone

(952) 473-3569

Fax

(952) 473-9526

NPI assigned

Oct 3, 2006

Organization subpart

No

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

Authorized official

Name

Jodi Ristau

Title

Director

Phone

(952) 936-2404

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• SNYDER DRUG EMPORIUM Doing business as

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218067200000",
    "number": "1124112529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14525 HIGHWAY 7",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553453734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1865 W WAYZATA BLVD",
            "city": "LONG LAKE",
            "state": "MN",
            "postal_code": "553569671",
            "telephone_number": "952-473-3569",
            "fax_number": "952-473-9526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNYDERS DRUG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-08-07",
        "status": "A",
        "authorized_official_last_name": "RISTAU",
        "authorized_official_first_name": "JODI",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "952-936-2404"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MN",
            "license": "2617844",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2683601 00",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2420103",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268360100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SNYDER DRUG EMPORIUM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joanna Rohlfsen, DDS
• Thomas David Ronning, DC
• Michael Walter Schwartz, D.C.
• Michael Joseph Sherman, CMT
• Douglas A Smith, M.D.
• Nicholas Stein, DC
• Paul John Thinesen, MA LP BCBA
• Tonka Life Center, LTD
• Water'S Edge Dental
• Angela Jean Weber, DCM

• Community/Retail Pharmacy in Long Lake, MN
• Providers in Long Lake, 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 Aug 7, 2008; 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.