Main Street Pharmacy Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

2605322 Issued in MN

Legal business name

MAIN STREET PHARMACY INC

Practice address

24 3Rd Street NE
Osseo, MN 55369

Phone

(763) 493-5242

Fax

(763) 493-2621

NPI assigned

Nov 22, 2006

Last updated

Apr 10, 2013By 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

Mr. Randall Alvin Hohbein, RPH

Title

Owner

Phone

(763) 493-5242

Specialties & licenses 1

Addresses

Other identifiers 3

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.

• Tracy Elizabeth Samson, RPH

  • Pharmacist
  • Osseo, MN
  • NPI 1942403340
  NPD (past)

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365552000000",
    "number": "1851466973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 3RD STREET NE",
            "city": "OSSEO",
            "state": "MN",
            "postal_code": "55369",
            "telephone_number": "763-493-5242",
            "fax_number": "763-493-2621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 3RD STREET NE",
            "city": "OSSEO",
            "state": "MN",
            "postal_code": "55369",
            "telephone_number": "763-493-5242",
            "fax_number": "763-493-2621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2013-04-10",
        "status": "A",
        "authorized_official_last_name": "HOHBEIN",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "ALVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-493-5242",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MN",
            "license": "2605322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF PHARMACY",
            "identifier": "2605322",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "2418526",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "484360600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Kirkwold, PHARMD
• Karissa Joy Klaers
• Snow Lee
• Hannah D Lewis, FNP-BC
• Lisa Roshanda Madden
• Steven James Mattson, PT
• Heidi Lee Mendenhall, D.C.
• Alicia Nicole Meyer, DPT
• Stephanie Motiff
• Jane Marie Murray, M.D.

• Pharmacy in Osseo, MN
• Providers in Osseo, MN by specialty
• Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.