Nya Pharmacy LLC
Organization Active NPI Community/Retail Pharmacy · Norwood, MN
NPI 1679938567 · NPPES record last updated Jan 8, 2019
Key facts
- NPI
- 1679938567
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 264871 (MN)
- Legal business name
- NYA PHARMACY LLC
- Practice address
- 402 Faxon Rd N
Norwood, MN 55368-9507 - Phone
- (952) 467-2100
- Fax
- (952) 467-2489
- NPI assigned
- Dec 21, 2015
- Organization subpart
- No
Authorized official
- Name
- Ryan Loegering, PHARMD
- Title
- President
- Phone
- (651) 334-7322
Corporate family (same tax ID) 1
Practitioners 1
-
Ellen Foltz, PHARMD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20161215001209 | MN | Part B Supplier - Mass Immunization (Roster Biller Only) | 7214217991 | Practice locations: Norwood Young America, MN |
| O20170310000522 | MN | DME Supplier - Pharmacy | 7214217991 | Practice locations: Norwood Young America, MN |
National Provider Directory
- Tax ID family
- Marsden Pharmacy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 264871 | MN | Yes |
Addresses
Primary practice location
402 Faxon Rd N
Norwood, MN 55368-9507
Mailing address
PO Box 600
Norwood Young America, MN 55368-0600
Phone (952) 467-2100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 561663000 | Medicaid | MN | |
| 2155598 | Other | PK |
Other names
- Marsden Pharmacy
Other providers in Norwood, MN
- Ellen Foltz
- Jeffrey A Indrelie
- Owen Michael McCann
- Metropolitan Eye Care Specialits, PA
- Norwood Dental
- Daniel J Ross
- Snyders Drug
- Waconia Pharmacy Inc
All providers in Norwood, MN · Community/Retail Pharmacy in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.