NPIMap

Organization Active NPI

Minnesota Oncology Hematology PA

Doing business as MN Cancer Care Pharmacy

  • Clinic Pharmacy
  • Maplewood, MN
National Provider Identifier
1144281304
Registry record updated Oct 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
261921 Issued in MN
Legal business name
MINNESOTA ONCOLOGY HEMATOLOGY PA
Doing business as
MN Cancer Care Pharmacy
Practice address
1580 Beam Ave
Maplewood, MN 55109-1127
Phone
(651) 255-8480
Fax
(651) 779-8989
NPI assigned
Mar 29, 2006
Last updated
Oct 6, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2015

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

Authorized official

Name
Brian Meger, PHARM DNPI 1730345380
Title
Pharmacy Manager
Phone
(651) 255-8480

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 261921 MN Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

1580 Beam Ave
Maplewood, MN 55109-1127

Mailing address

1580 Beam Ave
Maplewood, MN 55109-1127
Phone (651) 255-8480

Other identifiers 3

IdentifierTypeStateIssuer
215781100MedicaidMN
33234600MedicaidWI
2047904OtherPK

Other names 1

  • MN CANCER CARE PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930040661 MN DME Supplier - Pharmacy 6709799752 Practice locations: Maplewood, MN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Minnesota Cancer Care Pharmacy1580 Beam Ave, Maplewood, MN 55109-1127(651) 255-8480 Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jan 1, 1995

National Provider Directory

National Provider Directory
Tax ID family
Minnesota Oncology Hema26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

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": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444089600000",
    "number": "1144281304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 BEAM AVE",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091127",
            "telephone_number": "651-255-8480",
            "fax_number": "651-779-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 BEAM AVE",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091127",
            "telephone_number": "651-255-8480",
            "fax_number": "651-779-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA ONCOLOGY HEMATOLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-29",
        "last_updated": "2015-10-06",
        "status": "A",
        "authorized_official_last_name": "MEGER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "651-255-8480",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "MN",
            "license": "261921",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "215781100",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33234600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2047904",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MN CANCER CARE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.