Community Care Pharmacy PA

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2626385 Issued in MN

Legal business name

COMMUNITY CARE PHARMACY PA

Doing business as

Community Care Pharmacy

Practice address

102 2ND Ave NW
Saint Joseph, MN 56374-4106

Phone

(320) 271-1135

Fax

(320) 271-1137

NPI assigned

Jan 23, 2007

Last updated

Sep 12, 2007By 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

Gerald Wensmenn, PHARMD

Title

President

Phone

(320) 271-1135

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• COMMUNITY CARE PHARMACY Doing business as

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1528112976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "city": "SAINT JOSEPH",
            "state": "MN",
            "postal_code": "563740100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 2ND AVE NW",
            "city": "SAINT JOSEPH",
            "state": "MN",
            "postal_code": "563744106",
            "telephone_number": "320-271-1135",
            "fax_number": "320-271-1137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE PHARMACY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "WENSMENN",
        "authorized_official_first_name": "GERALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "320-271-1135",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "2626385",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "2427018",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2427018",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMMUNITY CARE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Amanda J Dircks, NP

• Community/Retail Pharmacy in Saint Joseph, MN
• Providers in Saint Joseph, 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 Sep 12, 2007; 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.