Nya Pharmacy LLC

Key facts

NPI

1780152306

Entity type

Organization (NPI type 2)

Primary specialty

Long Term Care Pharmacy 3336L0003X

Legal business name

NYA PHARMACY LLC

Practice address

402 Faxon Rd N
Norwood Young America, MN 55368-9507

Phone

(952) 467-2100

Fax

(952) 467-2489

NPI assigned

Nov 13, 2018

Organization subpart

No

Authorized official

Name

Ryan Loegering, PHARMD

Title

President

Phone

(651) 334-7322

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

• Nya Pharmacy LLC Community/Retail Pharmacy · Norwood, MN · NPI 1679938567
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephanie Loegering, PHARMD Geriatric Pharmacist · Waconia, MN · NPI 1942763834
  NPD (past)

National Provider Directory

Tax ID family

Marsden Pharmacy (2 organizations share this tax ID)

Specialties & licenses

Addresses

Other identifiers

Other names

• Marsden Pharmacy Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 13, 2018.

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542067200000",
    "number": "1780152306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 WILLIAM LAKE SHORE DR",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553879772",
            "telephone_number": "651-334-7322",
            "fax_number": "952-442-3284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 FAXON RD N",
            "city": "NORWOOD YOUNG AMERICA",
            "state": "MN",
            "postal_code": "553689507",
            "telephone_number": "952-467-2100",
            "fax_number": "952-467-2489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYA PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-13",
        "last_updated": "2018-11-13",
        "status": "A",
        "authorized_official_last_name": "LOEGERING",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-334-7322",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "561663000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marsden Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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