NPIMap

Organization Active NPI

Snyders Drug

Doing business as Snyder Drug Emporium

  • Community/Retail Pharmacy
  • Blaine, MN
National Provider Identifier
1235223637
Registry record updated Aug 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SNYDERS DRUG
Doing business as
Snyder Drug Emporium
Practice address
12521 Central Ave NE
Blaine, MN 55434-4861
Phone
(763) 755-8704
Fax
(763) 862-9097
NPI assigned
Oct 3, 2006
Last updated
Aug 6, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 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 2618144 MN
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

12521 Central Ave NE
Blaine, MN 55434-4861

Mailing address

14525 Highway 7
Minnetonka, MN 55345-3734

Other identifiers 3

IdentifierTypeStateIssuer
2413879OtherOTHER ID NUMBER-COMMERCIAL NUMBER
8205621 00MedicaidMN
820562100MedicaidMN

Other names 1

  • SNYDER 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

12521 Central Ave NE
Blaine, MN 55434
Phone (763) 755-8704

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": "1217980800000",
    "number": "1235223637",
    "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": "12521 CENTRAL AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554344861",
            "telephone_number": "763-755-8704",
            "fax_number": "763-862-9097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNYDERS DRUG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-08-06",
        "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": "2618144",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2413879",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8205621 00",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "820562100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SNYDER DRUG EMPORIUM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blaine, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.