Gregory B Amundson, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

120669 Issued in MN

Practice address

1175 Madison Ave
Mankato, MN 56001-5227

Phone

(507) 625-1791

NPI assigned

Mar 23, 2020

Last updated

Mar 23, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grand St Paul CVS LLC

  dba CVS Pharmacy # 11046

  • Pharmacy
  • Plymouth, MN
  • NPI 1437620903
  NPD (past)
• Grand St Paul CVS LLC

  dba CVS Pharmacy # 03054

  • Pharmacy
  • Mankato, MN
  • NPI 1700180692
  NPD (past)

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584921600000",
    "number": "1619504594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 MADISON AVE",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015227",
            "telephone_number": "507-625-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 MADISON AVE",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015227",
            "telephone_number": "507-625-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMUNDSON",
        "first_name": "GREGORY",
        "middle_name": "B",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-23",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "120669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eden Layne Ambrose, MA, LPCC
• Americare Mobility Van Inc.
• Americare Mobility Van LLP
• Amj Optometric Services PSC (Eye Q Vision)
• Amanda Apegyine Amoah
• Araceli Anaya
• Christina Anderley, MSW, LICSW
• Kari Andersen
• Anderson Family Chiropractic, LLC (Healthways Chiropractic and Integrated Wellness Center)
• Adam Anderson, PHD

• Pharmacist in Mankato, MN
• Providers in Mankato, MN by specialty
• Pharmacist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2020; 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.