Lakeville Snyder Drug

Primary specialty

PharmacyTaxonomy code 333600000X

License

260365-4 Issued in MN

Legal business name

LAKEVILLE SNYDER DRUG

Practice address

17665 Kenwood TRL
Lakeville, MN 55044-9455

Phone

(952) 435-3784

Fax

(952) 435-2050

NPI assigned

Aug 4, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Tim J Peterson

Title

Owner

Phone

(952) 435-3784

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1123113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1558362129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17665 KENWOOD TRL",
            "address_2": "LAKEVILLE SNYDER PHARMACY",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550449455",
            "telephone_number": "952-435-3784",
            "fax_number": "952-435-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17665 KENWOOD TRL",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550449455",
            "telephone_number": "952-435-3784",
            "fax_number": "952-435-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVILLE SNYDER DRUG",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-04",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "TIM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-435-3784",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MN",
            "license": "260365-4",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacy in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.