Warren Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

WARREN PHARMACY INC

Doing business as

Warren Pharmacy

Practice address

103 W Johnson Ave
Warren, MN 56762-1102

Phone

(218) 745-5481

Fax

(218) 745-5482

NPI assigned

Jul 30, 2006

Last updated

Jul 12, 2024By 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

Shelby Knott, PHARMDNPI 1952880668

Title

President, Shareholder, Pic

Phone

(218) 289-5859

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• WARREN PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in MN2 enrollments

Enrollment records 2

Tax ID family

Warren Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Warren Pharmacy Inc

  dba Warren Pharmacy LTC

  • Long Term Care Pharmacy
  • Warren, MN
  • NPI 1457198608
  NPD tax ID

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.

• Shelby Knott, PHARMD

  • Pharmacist
  • Warren, MN
  • NPI 1952880668
  NPD Authorized official

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720742400000",
    "number": "1871508481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 W JOHNSON AVE",
            "city": "WARREN",
            "state": "MN",
            "postal_code": "567621102",
            "telephone_number": "218-745-5481",
            "fax_number": "218-745-5482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W JOHNSON AVE",
            "city": "WARREN",
            "state": "MN",
            "postal_code": "567621102",
            "telephone_number": "218-745-5481",
            "fax_number": "218-745-5482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARREN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A",
        "authorized_official_last_name": "KNOTT",
        "authorized_official_first_name": "SHELBY",
        "authorized_official_title_or_position": "PRESIDENT, SHAREHOLDER, PIC",
        "authorized_official_telephone_number": "218-289-5859",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "418258800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2045164",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WARREN PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WARREN PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Warren Community Hospital, Inc. (North Valley Public Health)
• Warren Community Hospital, Inc. (North Valley Health Center)
• Warren Economic Development Authority (North Star Assisted Living)
• Warren Eye Care, P.C.
• Warren Pharmacy Inc (Warren Pharmacy LTC)
• Warren-Alvarado-Oslo Public School District No 2176
• Anita Whalen, DDS

• Community/Retail Pharmacy in Warren, MN
• Providers in Warren, 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 Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.