NPIMap

Organization Active NPI

Omc Retail Services LLC

Doing business as Olmsted Medical Center Northwest Pharmacy

  • Community/Retail Pharmacy
  • Rochester, MN
National Provider Identifier
1811241169
Registry record updated May 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
264014 Issued in MN
Legal business name
OMC RETAIL SERVICES LLC
Doing business as
Olmsted Medical Center Northwest Pharmacy
Practice address
5067 55TH St NW
Rochester, MN 55901-3809
Phone
(507) 535-1974
Fax
(507) 281-7685
NPI assigned
Nov 7, 2012
Last updated
May 30, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2017

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

Authorized official

Name
Danielle Roach, PHARMDNPI 1093064461
Title
Pharmacist
Phone
(507) 535-1974

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 264014 MN Primary

Addresses

Primary practice location

5067 55TH St NW
Rochester, MN 55901-3809

Mailing address

5067 55TH St NW
Rochester, MN 55901-3809
Phone (507) 535-1974

Other identifiers 2

IdentifierTypeStateIssuer
1811241169MedicaidMN
2137820OtherPK

Other names 1

  • Olmsted Medical Center Northwest Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20140630002191 MN Part B Supplier - Pharmacy 0143445486 1 other NPI on this enrollment
Practice locations: Rochester, MN
O20151228000709 MN Part B Supplier - Mass Immunization (Roster Biller Only) 0143445486 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rochester, MN
O20161215001423 MN DME Supplier - Pharmacy 0143445486 Practice locations: Rochester, MN

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Omc Retail Services LLC5067 55TH St NW, Rochester, MN 55901-3809(507) 535-1974 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Ostomy Supplies|Urological Supplies|Enteral Nutrients|Parente… Accepts assignmentParticipating since Mar 1, 2015

National Provider Directory

National Provider Directory
Tax ID family
Olmsted Medical Center Chatfield Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496102400000",
    "number": "1811241169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5067 55TH ST NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559013809",
            "telephone_number": "507-535-1974",
            "fax_number": "507-281-7685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5067 55TH ST NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559013809",
            "telephone_number": "507-535-1974",
            "fax_number": "507-281-7685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMC RETAIL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-07",
        "last_updated": "2017-05-30",
        "status": "A",
        "authorized_official_last_name": "ROACH",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "507-535-1974",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "264014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811241169",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2137820",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Olmsted Medical Center Northwest Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2017; 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.