NPIMap

Organization Active NPI

Thrifty Drug Stores Inc

  • Pharmacy
  • Baudette, MN
National Provider Identifier
1477053577
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
265503 Issued in MN
Legal business name
THRIFTY DRUG STORES INC
Practice address
111 N Main Ave
Baudette, MN 56623-2466
Phone
(218) 634-1236
Fax
(218) 634-1276
NPI assigned
Feb 15, 2018
Last updated
Jul 31, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Authorized official

Name
Anne Brader
Title
Cfo
Phone
(763) 513-4300

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X 265503 MN Primary
Community/Retail Pharmacy 3336C0003X
Long Term Care Pharmacy 3336L0003X
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

111 N Main Ave
Baudette, MN 56623-2466

Mailing address

6701 Evenstad Dr N Ste 100
Maple Grove, MN 55369-6013
Phone (763) 513-4300

Other identifiers 1

IdentifierTypeStateIssuer
2176102OtherPK

Other names 1

  • Thrifty White Pharmacy #791 Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041104000521 MN Part B Supplier - Mass Immunization (Roster Biller Only) 0941269047 This NPI is an additional NPI on the enrollment
Practice locations: Sandstone, MN; Rochester, MN; Red Lake Falls, MN; Plymouth, MN; Mankato, MN; Pierz, MN; Olivia, MN; Morris, MN…
O20180601000028 MN DME Supplier - Pharmacy 0941269047 Practice locations: Baudette, MN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D2223938Thrifty White Pharmacy #791111 N Main Ave, PO Box 460, Baudette, MN 56623Certificate of waiverMar 20, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Thrifty White Pharmacy #791111 N Main Ave, Baudette, MN 56623-2466(218) 634-1236 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Orthoses: Off-The-Shelf|Ostomy Supplies|Nebulizer Equipment a… Accepts assignmentParticipating since Jan 1, 2024

National Provider Directory

National Provider Directory
Tax ID family
Thrifty White Drug 71043 organizations share this tax ID, including this one

Other organizations with this tax ID 42

Organizations that report the same tax identification number in the National Provider Directory.

View all 42

Locations

6055 Nathan Ln N
Plymouth, MN 55442
Phone (763) 463-4400

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St Luke Lutheran Nursing HomeSpencer, IA, CCN 165484 Skilled nursing facility Adp of the SNF Jan 1, 2025
Good Samaritan Society - MaplewoodMaplewood, MN, CCN 245221 Skilled nursing facility Adp of the SNF Aug 1, 2017
Good Samaritan Society - AmbassadorNew Hope, MN, CCN 245149 Skilled nursing facility Adp of the SNF Aug 1, 2017
Good Samaritan Society - Inver Grove HeightsInver Grove Heights, MN, CCN 245285 Skilled nursing facility Adp of the SNF Aug 1, 2017
Good Samaritan Society - Specialty Care CommunityRobbinsdale, MN, CCN 245279 Skilled nursing facility Adp of the SNF Aug 1, 2017
Good Samaritan Society - ComforcareAustin, MN, CCN 245317 Skilled nursing facility Adp of the SNF Aug 1, 2017

NPI Registry JSON

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

{
    "created_epoch": "1518652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785456000000",
    "number": "1477053577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 EVENSTAD DR N STE 100",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553696013",
            "telephone_number": "763-513-4300"
        },
        {
            "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": "THRIFTY DRUG STORES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-15",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A",
        "authorized_official_last_name": "BRADER",
        "authorized_official_first_name": "ANNE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "763-513-4300"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MN",
            "license": "265503",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2176102",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thrifty White Pharmacy #791",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baudette, MN

Sources for this page

Verify at the official NPI Registry.