Organization Active NPI

Elko New Market Family Pharmacy, LLC

  • Community/Retail Pharmacy
  • Elko New Market, MN
National Provider Identifier
1134745730
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
ELKO NEW MARKET FAMILY PHARMACY, LLC
Practice address
117 Old Town Road
Elko New Market, MN 55054
Phone
(507) 412-5712
Fax
(507) 412-8291
NPI assigned
Jun 19, 2020
Last updated
Jul 16, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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

Authorized official

Name
Dr. Matthew Steven Pivec, PHARMDNPI 1477944437
Title
Pharmacist/Owner
Phone
(507) 412-5712

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

117 Old Town Road
Elko New Market, MN 55054

Mailing address

117 Old Town Road
Elko New Market, MN 55054
Phone (507) 412-5712

Other identifiers 1

IdentifierTypeStateIssuer
266091OtherMNMN BOARD OF PHARMACY

National Provider Directory

National Provider Directory

Locations

117 Old Town Rd
Elko New Market, MN 55054
Phone (507) 412-5712

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594857600000",
    "number": "1134745730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 OLD TOWN ROAD",
            "city": "ELKO NEW MARKET",
            "state": "MN",
            "postal_code": "55054",
            "telephone_number": "507-412-5712",
            "fax_number": "507-412-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 OLD TOWN ROAD",
            "city": "ELKO NEW MARKET",
            "state": "MN",
            "postal_code": "55054",
            "telephone_number": "507-412-5712",
            "fax_number": "507-412-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELKO NEW MARKET FAMILY PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-19",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A",
        "authorized_official_last_name": "PIVEC",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "507-412-5712",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BOARD OF PHARMACY",
            "identifier": "266091",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elko New Market, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; 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.