Anderson Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2047142 Issued in MN

Legal business name

ANDERSON PHARMACY

Practice address

115 S 2ND
Hallock, MN 56728

Phone

(218) 843-2205

Fax

(218) 843-2205

NPI assigned

Dec 14, 2006

Last updated

Sep 28, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Harold G Anderson, RPH

Title

Owner RPH

Phone

(218) 843-2205

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190937600000",
    "number": "1184786782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BX 99",
            "address_2": "115 S 2ND",
            "city": "HALLOCK",
            "state": "MN",
            "postal_code": "56728",
            "telephone_number": "218-843-2205",
            "fax_number": "218-843-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S 2ND",
            "city": "HALLOCK",
            "state": "MN",
            "postal_code": "56728",
            "telephone_number": "218-843-2205",
            "fax_number": "218-843-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-09-28",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER RPH",
        "authorized_official_telephone_number": "218-843-2205",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "2047142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274357400",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMBINED SUBTURE REGISTER",
            "identifier": "AA7257276",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremy Anderson
• Kristin Marie Atwood, OD
• Julie A. J. Johnson, FNP
• Kittson Central School District #2171
• Kittson County

• Community/Retail Pharmacy in Hallock, MN
• Providers in Hallock, 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 Sep 28, 2007; 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.