NPIMap

Organization Active NPI

Minimed Distribution Corp.

  • Mail Order Pharmacy
  • San Antonio, TX
National Provider Identifier
1831418672
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mail Order PharmacyTaxonomy code 3336M0002X
Legal business name
MINIMED DISTRIBUTION CORP.
Doing business as
Medtronic Pharmacy
Practice address
18302 Talavera RDG
San Antonio, TX 78257-2605
Phone
(210) 395-5500
NPI assigned
May 19, 2010
Organization subpart
Yes
Parent organization
MINIMED DISTRIBUTION CORP.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Authorized official

Name
Angela E Ward
Title
Principal Operations Specialist
Phone
(804) 550-2017

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Mail Order Pharmacy 3336M0002X Primary

Addresses

Primary practice location

18302 Talavera RDG
San Antonio, TX 78257-2605

Mailing address

18000 Devonshire St
Northridge, CA 91325-1219
Phone (800) 646-4633

Other names 1

  • Medtronic Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141004000001 TX DME Supplier - PharmacyDME Supplier - Medical Supply Company 7911028303 Practice locations: San Antonio, TX

Other NPIs with the same Medicare PAC ID 1

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

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
Minimed Distribution Corp18302 Talavera RDG, San Antonio, TX 78257-2605(877) 891-6750 Blood Glucose Monitors/Supplies (Mail Order)|Insulin Infusion Pumps and/or Supplies Accepts assignmentParticipating since Jan 1, 2002

National Provider Directory

National Provider Directory
Tax ID family
Minimed Distribution Corp18 organizations share this tax ID, including this one
Part of
Minimed Distribution Corp

Other organizations with this tax ID 17

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

View all 17

Locations

18302 Talavera Rdg
San Antonio, TX 78257
Phone (210) 395-5500

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1274227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650931200000",
    "number": "1831418672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18000 DEVONSHIRE ST",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913251219",
            "telephone_number": "800-646-4633",
            "fax_number": "818-739-4414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18302 TALAVERA RDG",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782572605",
            "telephone_number": "210-395-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINIMED DISTRIBUTION CORP.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MINIMED DISTRIBUTION CORP.",
        "enumeration_date": "2010-05-19",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRINCIPAL OPERATIONS SPECIALIST",
        "authorized_official_telephone_number": "804-550-2017"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medtronic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medtronic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; 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.