Snyders Drug Store Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SNYDERS DRUG STORE INC

Practice address

1037 Highway 96 W
Shoreview, MN 55126-1914

Phone

(651) 483-3823

Fax

(651) 765-1956

NPI assigned

Oct 3, 2006

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": "1227484800000",
    "number": "1598859993",
    "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": "1037 HIGHWAY 96 W",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551261914",
            "telephone_number": "651-483-3823",
            "fax_number": "651-765-1956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNYDERS DRUG STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-11-24",
        "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": "2617983",
            "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": "1907620 00",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190762000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2414833",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SNYDER DRUG EMPORIUM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Shoreview, MN
• Providers in Shoreview, 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 Nov 24, 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.