J & R Rexall Drug

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2049412 Issued in MN

Legal business name

J & R REXALL DRUG

Practice address

107 Downtown PLZ
Fairmont, MN 56031-1726

Phone

(507) 235-9719

Fax

(507) 235-9696

NPI assigned

Aug 12, 2006

Organization subpart

No

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

Authorized official

Name

James Marcovich

Title

Owner

Phone

(507) 235-9719

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1437161023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 DOWNTOWN PLZ",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560311726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 DOWNTOWN PLZ",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560311726",
            "telephone_number": "507-235-9719",
            "fax_number": "507-235-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J & R REXALL DRUG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-12",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "MARCOVICH",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "507-235-9719"
    },
    "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": "2049412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "384757800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "2402701",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Fairmont, MN
• Providers in Fairmont, 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 Jun 18, 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.