Casey Drug-a Inc
Organization Active NPI Community/Retail Pharmacy · Chisholm, MN
NPI 1801909825 · NPPES record last updated Mar 17, 2022
Key facts
- NPI
- 1801909825
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 261315 (MN)
- Legal business name
- CASEY DRUG-A INC
- Practice address
- 121 W Lake St
Chisholm, MN 55719-1818 - Phone
- (218) 254-3318
- Fax
- (218) 254-7643
- NPI assigned
- Aug 16, 2006
- Organization subpart
- No
Authorized official
- Name
- Alida Casey, PHARMD
- Title
- Owner/RPH
- Phone
- (218) 254-3318
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Practitioners 2
-
Aden Casey, PHARMD
-
Alida Erin Casey, PHARM D
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930053749 | MN | DME Supplier - Pharmacy | 3274654819 | Practice locations: Chisholm, MN |
| O20200618002466 | MN | Part B Supplier - Pharmacy | 3274654819 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Chisholm, MN |
National Provider Directory
- Tax ID family
- Casey Drug
Locations
111 W Lake St
Chisholm, MN 55719
Phone (218) 254-3318
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 261315 | MN | Yes |
| Long Term Care Pharmacy | 3336L0003X |
Addresses
Primary practice location
121 W Lake St
Chisholm, MN 55719-1818
Mailing address
121 W Lake St
Chisholm, MN 55719-1818
Phone (218) 254-3318
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2044144 | Other | PK | |
| 340560500 | Medicaid | MN |
Other names
- CASEY DRUG
Other providers in Chisholm, MN
- Kayla Miller Bechthold
- Christi Brooks
- Melissa Sue Brusacoram
- Karen Marie Butkovich
- Casey Drug-a Inc
- Aden Casey
- Alida Erin Casey
- Children'S Dental Services
- Chisholm Dental Service PA
- Chisholm Health Center
All providers in Chisholm, 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 Mar 17, 2022. 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.