W & C Apothecary

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

263665 Issued in MN

Legal business name

W & C APOTHECARY

Doing business as

The Apothecary

Practice address

165 19TH St S
Suite 102
Sartell, MN 56377-2153

Phone

(320) 251-0107

Fax

(320) 251-0979

NPI assigned

Nov 29, 2006

Last updated

Mar 14, 2011By 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. Stephen G Anderson, R.PH

Title

Owner

Phone

(320) 251-0107

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Apothecary Doing business as

Locations

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300060800000",
    "number": "1376610899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 19TH ST S",
            "address_2": "SUITE 102",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772153",
            "telephone_number": "320-251-0107",
            "fax_number": "320-251-0979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 19TH ST S",
            "address_2": "SUITE 102",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772153",
            "telephone_number": "320-251-0107",
            "fax_number": "320-251-0979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W & C APOTHECARY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2011-03-14",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-251-0107",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "MN",
            "license": "263665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006360600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Apothecary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Compounding Pharmacy in Sartell, MN
• Providers in Sartell, MN by specialty
• Compounding Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2011; 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.