Snyders Drug

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SNYDERS DRUG

Doing business as

Snyder Drug Emporium

Practice address

915 Wildwood Rd
White Bear Lake, MN 55115-1847

Phone

(651) 777-8121

Fax

(651) 777-4868

NPI assigned

Oct 3, 2006

Last updated

Aug 7, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jodi Ristau

Title

Director

Phone

(952) 936-2404

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• SNYDER DRUG EMPORIUM Doing business as

Locations

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218067200000",
    "number": "1497849897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14525 HIGHWAY 7",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553453734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 WILDWOOD RD",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551151847",
            "telephone_number": "651-777-8121",
            "fax_number": "651-777-4868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNYDERS DRUG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-08-07",
        "status": "A",
        "authorized_official_last_name": "RISTAU",
        "authorized_official_first_name": "JODI",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "952-936-2404"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MN",
            "license": "2619525",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5291038 00",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2418110",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529103800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SNYDER DRUG EMPORIUM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah Slattery, PA-C
• Laura Lenee Slings, MD
• Leah Marie Sluis
• Dennis A Smith, M.S.W.
• Michael C. Smith
• Snyders Drug (Snyders Drug Store)
• Tabitha Soderstrom, MS
• Soleck Ventures Inc (FYZICAL Therapy and Balance Centers)
• John Solomon, LPC
• Abigail Solorzano

• Community/Retail Pharmacy in White Bear Lake, MN
• Providers in White Bear 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 Aug 7, 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.