Waconia Pharmacy

Primary specialty

Clinic PharmacyTaxonomy code 3336C0002X

License

262330-4 Issued in MN

Legal business name

WACONIA PHARMACY

Practice address

430 Highway 5 West
Waconia, MN 55387-1795

Phone

(952) 442-3274

Fax

(952) 442-3284

NPI assigned

Oct 26, 2006

Last updated

Aug 22, 2020By 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

John Marsden, RPH

Title

Owner

Phone

(952) 442-3274

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407931553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 HIGHWAY 5 WEST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871795",
            "telephone_number": "952-442-3274",
            "fax_number": "952-442-3284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 HIGHWAY 5 WEST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871795",
            "telephone_number": "952-442-3274",
            "fax_number": "952-442-3284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WACONIA PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARSDEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-442-3274",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "MN",
            "license": "262330-4",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Waconia School District
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• Christy Anne Wallen, CPD, CD, CPDT,
• Katelynn Marie Walsh, MS, LAT, ATC, EMT
• Jordyn Nicole Walter, MD

• Clinic Pharmacy in Waconia, MN
• Providers in Waconia, MN by specialty
• Clinic Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.