Hanson Northdale Drug

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2601504 Issued in MN

Legal business name

HANSON NORTHDALE DRUG

Practice address

544 Northdale Blvd NW
Coon Rapids, MN 55448-3366

Phone

(763) 755-2200

Fax

(763) 755-7328

NPI assigned

Jan 30, 2007

Organization subpart

No

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

Authorized official

Name

Gary Benson

Title

Owner

Phone

(763) 755-2200

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1386780997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 NORTHDALE BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554483366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 NORTHDALE BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554483366",
            "telephone_number": "763-755-2200",
            "fax_number": "763-755-7328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANSON NORTHDALE DRUG",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "BENSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-755-2200"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "2601504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2402446",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "2402446",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2601504",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kristen Hansel
• Anna Hansmann
• Ashley M Hansmann, CRNA
• Jennifer Lynn Hanson
• Nicole Hanson, LICSW
• Sarah M. Hanson, DO
• Yoshiko Nakagawa Hapke, MD
• Keyona Lynn Hardin

• Community/Retail Pharmacy in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Community/Retail Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; 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.