SMN Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

260648 Issued in MN

Legal business name

SMN INC

Practice address

111 N Main Ave
Baudette, MN 56623-2466

Phone

(218) 634-1236

Fax

(218) 634-1276

NPI assigned

Jun 16, 2005

Organization subpart

No

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

Authorized official

Name

Stuart Noble, RPH

Title

Pharmacist and Owner

Phone

(218) 634-1236

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• NOBLE DRUG Doing business as

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487203200000",
    "number": "1447255385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 848",
            "city": "BAUDETTE",
            "state": "MN",
            "postal_code": "566230848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N MAIN AVE",
            "city": "BAUDETTE",
            "state": "MN",
            "postal_code": "566232466",
            "telephone_number": "218-634-1236",
            "fax_number": "218-634-1276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-16",
        "last_updated": "2017-02-16",
        "status": "A",
        "authorized_official_last_name": "NOBLE",
        "authorized_official_first_name": "STUART",
        "authorized_official_title_or_position": "PHARMACIST AND OWNER",
        "authorized_official_telephone_number": "218-634-1236",
        "authorized_official_credential": "RPH"
    },
    "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": "260648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2046647",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "895560300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NOBLE DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stuart Michael Noble, RPH
• Brennin Kyle O'Brien, PHARMD
• Psychenutrition
• Justin Quo, M.D.
• Sanford Health of Northern Minnesota
• Taylored Care Services LLC
• Thrifty Drug Stores Inc
• Shawna Renae Brasgalla Wendler
• David Clark Wohlrabe, D.D.S.
• Robert Anthony Wolfe, MD

• All providers in Baudette, MN
• Community/Retail Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; 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.