NPIMap

Organization Active NPI

Snyders Drug

Doing business as Synder Drug Emporium

  • Community/Retail Pharmacy
  • Minnetonka, MN
National Provider Identifier
1215021613
Registry record updated Aug 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SNYDERS DRUG
Doing business as
Synder Drug Emporium
Practice address
14625 Excelsior Blvd
Minnetonka, MN 55345-6605
Phone
(952) 932-9058
Fax
(952) 908-1169
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2008

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

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 2617750 MN
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

14625 Excelsior Blvd
Minnetonka, MN 55345-6605

Mailing address

14525 Highway 7
Minnetonka, MN 55345-3734

Other identifiers 3

IdentifierTypeStateIssuer
1482602 00MedicaidMN
148260200MedicaidMN
2419996OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • SYNDER DRUG EMPORIUM Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Snyder Drug Emporium43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

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

View all 42

Locations

14625 Excelsior Blvd
Minnetonka, MN 55345
Phone (952) 932-9058

NPI Registry JSON

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": "1215021613",
    "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": "14625 EXCELSIOR BLVD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553456605",
            "telephone_number": "952-932-9058",
            "fax_number": "952-908-1169"
        }
    ],
    "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": "2617750",
            "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": "1482602 00",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148260200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2419996",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SYNDER DRUG EMPORIUM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minnetonka, MN

Sources for this page

  • 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.