Lake Elmo Pharmacy

Primary specialty

PharmacistTaxonomy code 183500000X

License

2611044 Issued in MN

Legal business name

LAKE ELMO PHARMACY

Practice address

11240 Stillwater Blvd N
Lake Elmo, MN 55042-9640

Phone

(651) 773-0889

NPI assigned

Feb 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Nicholas R Rich, PHARMD

Title

Pharmacist

Phone

(651) 773-0889

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710012646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11240 STILLWATER BLVD N",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550429640",
            "telephone_number": "651-773-0889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11240 STILLWATER BLVD N",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550429640",
            "telephone_number": "651-773-0889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE ELMO PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RICH",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "651-773-0889",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "2611044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP NUMBER",
            "identifier": "2419275",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Lake Elmo, MN
• Providers in Lake Elmo, MN by specialty
• Pharmacist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.