Active NPI
Jerry'S Enterprises, Inc
- Community/Retail Pharmacy
- North Branch, MN
National Provider Identifier
1265084792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- JERRY'S ENTERPRISES, INC
- Practice address
- 5418 Saint Croix TRL
North Branch, MN 55056-4203 - Phone
- (651) 243-5325
- Fax
- (651) 243-5324
- NPI assigned
- Jul 15, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ann Marie Mell, DOCTOR OF PHARMACY
- Title
- Pharmacist in Charge
- Phone
- (651) 243-5325
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
5418 Saint Croix TRL
North Branch, MN 55056-4203
Mailing address
PO Box 640
Conrad, IA 50621-0640
Phone (641) 366-3440
Other names 1
- Jerry's Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131106000139 | MN | Part B Supplier - Pharmacy | 5395907141 |
5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Hawley, MN; Paynesville, MN |
Other NPIs on the same Medicare enrollment 3
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563148800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788912000000",
"number": "1265084792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 640",
"city": "CONRAD",
"state": "IA",
"postal_code": "506210640",
"telephone_number": "641-366-3440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5418 SAINT CROIX TRL",
"city": "NORTH BRANCH",
"state": "MN",
"postal_code": "550564203",
"telephone_number": "651-243-5325",
"fax_number": "651-243-5324"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JERRY'S ENTERPRISES, INC",
"organizational_subpart": "NO",
"enumeration_date": "2019-07-15",
"last_updated": "2026-09-09",
"status": "A",
"authorized_official_last_name": "MELL",
"authorized_official_first_name": "ANN",
"authorized_official_middle_name": "MARIE",
"authorized_official_title_or_position": "PHARMACIST IN CHARGE",
"authorized_official_telephone_number": "651-243-5325",
"authorized_official_credential": "DOCTOR OF PHARMACY"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Jerry's Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in North Branch, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.