Prairiecare LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

264804 Issued in MN

Legal business name

PRAIRIECARE LLC

Practice address

9400 Zane Ave N
Brooklyn Park, MN 55443-1814

Phone

(763) 762-8800

Fax

(763) 315-4469

NPI assigned

Nov 3, 2017

Organization subpart

Yes

Parent organization

PRAIRIECARE LLCAs reported in NPPES

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

Authorized official

Name

John Egan Ryan, JD

Title

General Counsel

Phone

(763) 762-6802

Specialties & licenses 1

Addresses

Other names 1

• PrairieCare Doing business as

Tax ID family

Prairiecare LLC2 organizations share this tax ID, including this one

Part of

Prairiecare LLC

Other organizations with this tax ID 1

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

• Prairiecare LLC

  • Psychiatric Hospital
  • Brooklyn Park, MN
  • NPI 1215182928
  NPD tax ID

Practitioners 1

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

• Todd Archbold, LSW

  • Social Worker
  • Maple Grove, MN
  • NPI 1902272685
  NPD

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

{
    "created_epoch": "1509667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618531200000",
    "number": "1508378167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 ZANE AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431814",
            "telephone_number": "763-762-8800",
            "fax_number": "763-315-4469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 ZANE AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431814",
            "telephone_number": "763-762-8800",
            "fax_number": "763-315-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIECARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRAIRIECARE LLC",
        "enumeration_date": "2017-11-03",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "EGAN",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "763-762-6802",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "264804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PrairieCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Polar Health Services
• Zachary Polzin, MA
• Erika L Posthumus, LICSW
• Prairie Seeds Academy
• Prairiecare LLC
• Lynndelle Kristin Pratt, M.S., LMFT
• Precious Hands Pca LLC
• Precious Home Service Inc.
• Preferred Nursing Services Inc
• Premium Home Healthcare LLC

• All providers in Brooklyn Park, MN
• Community/Retail Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.