Individual provider Active NPI

Ben Earl Anderson, PHARMD

  • Pharmacist
  • Cloquet, MN
National Provider Identifier
1770725582
Registry record updated Mar 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
117495 Issued in MN
Practice address
927 Trettel Lane
Fond Du Lac Human Services Division
Cloquet, MN 55720-8247
Phone
(218) 878-2185
Fax
(218) 878-3755
NPI assigned
Mar 26, 2009
Last updated
Mar 26, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 117495 MN Primary

Addresses

Primary practice location

927 Trettel Lane
Fond Du Lac Human Services Division
Cloquet, MN 55720-8247

Mailing address

927 Trettel Lane
Fond Du Lac Human Services Division
Cloquet, MN 55720-8247
Phone (218) 878-2185

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
117495MNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1238025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238025600000",
    "number": "1770725582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 TRETTEL LANE",
            "address_2": "FOND DU LAC HUMAN SERVICES DIVISION",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557208247",
            "telephone_number": "218-878-2185",
            "fax_number": "218-878-3755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 TRETTEL LANE",
            "address_2": "FOND DU LAC HUMAN SERVICES DIVISION",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557208247",
            "telephone_number": "218-878-2185",
            "fax_number": "218-878-3755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "BEN",
        "middle_name": "EARL",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-26",
        "last_updated": "2009-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "117495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cloquet, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2009; 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.