Active NPI
Lance Lundstad, RPH
- Pharmacist
- Red Wing, MN
National Provider Identifier
1578938353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 119193
- Practice address
- 151 Tyler Rd N
Red Wing, MN 55066-1865 - Phone
- (651) 388-2433
- NPI assigned
- Dec 5, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 119193 | MN | Primary |
| Pharmacist | 183500000X | 12304 | WI |
Addresses
Primary practice location
151 Tyler Rd N
Red Wing, MN 55066-1865
Mailing address
PO Box 821
Lindstrom, MN 55045-0821
Phone (507) 458-1217
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 119193 | MN | MD | Pharmacist |
| 12304 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449273600000",
"number": "1578938353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 821",
"city": "LINDSTROM",
"state": "MN",
"postal_code": "550450821",
"telephone_number": "507-458-1217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 TYLER RD N",
"city": "RED WING",
"state": "MN",
"postal_code": "550661865",
"telephone_number": "651-388-2433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNDSTAD",
"first_name": "LANCE",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-12-05",
"last_updated": "2015-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "119193",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "12304",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Red Wing, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.