Mackenthun Beck Pharmacy, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

262255-4 Issued in MN

Legal business name

MACKENTHUN BECK PHARMACY, INC

Doing business as

Beck Pharmacy

Practice address

851 Marketplace Dr
Waconia, MN 55387-1548

Phone

(952) 442-4407

Fax

(952) 442-5787

NPI assigned

Feb 28, 2007

Last updated

Apr 22, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Jessa Theis

Title

Owner

Phone

(952) 442-5765

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Beck Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in MN2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jessica R Bonifas, PHARMD

  • Pharmacist
  • Waconia, MN
  • NPI 1497752174
  NPD

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240358400000",
    "number": "1801924303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 MARKETPLACE DR",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871548",
            "telephone_number": "952-442-4407",
            "fax_number": "952-442-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 MARKETPLACE DR",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871548",
            "telephone_number": "952-442-4407",
            "fax_number": "952-442-5787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACKENTHUN BECK PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2009-04-22",
        "status": "A",
        "authorized_official_last_name": "THEIS",
        "authorized_official_first_name": "JESSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-442-5765",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MN",
            "license": "262255-4",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "262255-4",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "588678000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beck Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie Loegering, PHARMD
• Melissa Londono, OTR/L
• Benjamin Long
• Bradley J Ludwig, O.D.
• Emily Taylor Ludwigson
• Mackenthun Supermarkets, Inc. (Mackenthun's Fine Foods)
• Yalda Mahinfalah
• Kim A Maletta Shibley, MD
• Prasun Mandal, DO
• Alex Jacob Mangan, MD

• Community/Retail Pharmacy in Waconia, MN
• Providers in Waconia, MN by specialty
• Community/Retail Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.