NPIMap

Organization Active NPI

Banadir Pharmacy LLC

Doing business as Banadir Pharmacy

  • Community/Retail Pharmacy
  • Minneapolis, MN
National Provider Identifier
1487923488
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
263804 Issued in MN
Legal business name
BANADIR PHARMACY LLC
Doing business as
Banadir Pharmacy
Practice address
1 W Lake St Ste 195
Minneapolis, MN 55408-3362
Phone
(612) 825-1669
Fax
(612) 825-1667
NPI assigned
Dec 20, 2011
Last updated
May 1, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2017

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

Authorized official

Name
Edris KosarNPI 1831332758
Title
Owner/Pharmacist in Charge
Phone
(267) 575-1293

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 263804 MN Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

1 W Lake St Ste 195
Minneapolis, MN 55408-3362

Mailing address

1 W Lake St Ste 195
Minneapolis, MN 55408-3362
Phone (612) 825-1669

Other names 1

  • Banadir Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

1 W Lake St
Ste 195
Minneapolis, MN 55408
Phone (612) 259-7570

405 E Lake St
Minneapolis, MN 55408

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1324339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493596800000",
    "number": "1487923488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W LAKE ST STE 195",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554083362",
            "telephone_number": "612-825-1669",
            "fax_number": "612-825-1667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W LAKE ST STE 195",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554083362",
            "telephone_number": "612-825-1669",
            "fax_number": "612-825-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANADIR PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-20",
        "last_updated": "2017-05-01",
        "status": "A",
        "authorized_official_last_name": "KOSAR",
        "authorized_official_first_name": "EDRIS",
        "authorized_official_title_or_position": "OWNER/PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "267-575-1293"
    },
    "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": "263804",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Banadir Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.