Lakes Snyder Drug, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

261427-4 Issued in MN

Legal business name

LAKES SNYDER DRUG, INC

Practice address

808 Lake St S
Forest Lake, MN 55025-2614

Phone

(651) 464-5518

Fax

(651) 464-1513

NPI assigned

Oct 23, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Dan John Hagen, RPHNPI 1609216019

Title

President

Phone

(651) 464-5518

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dan John Hagen, RPH

  • Pharmacist
  • Forest Lake, MN
  • NPI 1609216019
  NPD (past) Authorized official

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202947200000",
    "number": "1497838759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 LAKE ST S",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550252614",
            "telephone_number": "651-464-5518",
            "fax_number": "651-464-1513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 LAKE ST S",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550252614",
            "telephone_number": "651-464-5518",
            "fax_number": "651-464-1513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKES SNYDER DRUG, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2008-02-14",
        "status": "A",
        "authorized_official_last_name": "HAGEN",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-464-5518",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "261427-4",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2422107",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Pearl Kunz, LMT
• Lakes Area Human Services, Inc.
• Lakes Center for Youth and Families
• Lakes Dental Assoc PA
• Lakes International Language Academy
• Lakewoods Chiropractic P.a.
• Rita Lambrecht, PT
• Christensia Neng Larkey, MBA
• Brant Adam Larsen, BRANT LARSEN D.C.
• Peter D Larson, DPT

• Community/Retail Pharmacy in Forest Lake, MN
• Providers in Forest Lake, 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 Feb 14, 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.