St Peter Pharmacy LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

263914 Issued in MN

Legal business name

ST PETER PHARMACY LLC

Doing business as

Falcon Compounding

Practice address

1801 Old Highway 8 NW Ste 121
New Brighton, MN 55112-2307

Phone

(651) 788-7346

Fax

(651) 340-1294

NPI assigned

Sep 20, 2006

Last updated

May 1, 2017By 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

Cassandra Lyman

Title

Partner

Phone

(651) 788-7346

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Falcon Compounding Doing business as

Locations

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493596800000",
    "number": "1871690974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 OLD HIGHWAY 8 NW STE 121",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551122307",
            "telephone_number": "651-788-7346",
            "fax_number": "651-340-1294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 OLD HIGHWAY 8 NW STE 121",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551122307",
            "telephone_number": "651-788-7346",
            "fax_number": "651-340-1294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST PETER PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2017-05-01",
        "status": "A",
        "authorized_official_last_name": "LYMAN",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "651-788-7346"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "MN",
            "license": "263914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2121976",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "035858400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Falcon Compounding",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Compounding Pharmacy in New Brighton, MN
• Providers in New Brighton, MN by specialty
• Compounding Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; 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.