Jill Landecker, PHARM.D.

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

118874 Issued in MN

Practice address

3550 Vicksburg LN N
Plymouth, MN 55447-1322

Phone

(763) 553-2727

Fax

(763) 557-9554

NPI assigned

Aug 23, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Supervalu Pharmacies Inc

  • Community/Retail Pharmacy
  • Plymouth, MN
  • NPI 1215042353
  NPD (past)

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

{
    "created_epoch": "1408752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408752000000",
    "number": "1225438583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 VICKSBURG LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554471322",
            "telephone_number": "763-553-2727",
            "fax_number": "763-557-9554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 VICKSBURG LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554471322",
            "telephone_number": "763-553-2727",
            "fax_number": "763-557-9554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDECKER",
        "first_name": "JILL",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-23",
        "last_updated": "2014-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MN",
            "license": "118874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breanna Rae Lambach, DC
• Taylor Ilten Lambrecht
• Megan Marie Lampright
• Land of Lakes Orthotics & Prosthetics
• Randy James Landa, D.D.S.
• George Harold Landis, MD
• Kristeen Joanne Laplant Young, LPCC, LADC
• Jessica Lynn Larkin, D.C.
• Kelly Jean Larsgard
• Andrew Jon Larson, D.O.

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2014; 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.