Organization Active NPI

Chanhassen Center Drug

  • Community/Retail Pharmacy
  • Chaska, MN
National Provider Identifier
1891807897
Registry record updated Jan 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2625522 Issued in MN
Legal business name
CHANHASSEN CENTER DRUG
Doing business as
Chanhassen Center Drug
Practice address
111 Hundertmark Rd Ste 100
Chaska, MN 55318-1194
Phone
(952) 949-1002
Fax
(952) 949-0233
NPI assigned
Aug 31, 2006
Last updated
Jan 22, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2016

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

Authorized official

Name
Bruce Anderson
Title
RPH
Phone
(952) 949-1002

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 2625522 MN Primary
Long Term Care Pharmacy 3336L0003X NU

Addresses

Primary practice location

111 Hundertmark Rd Ste 100
Chaska, MN 55318-1194

Mailing address

111 Hundertmark Rd
Suite 100
Chaska, MN 55318-4551
Phone (952) 949-1002

Other identifiers 2

IdentifierTypeStateIssuer
099560600MedicaidMN
2046933OtherPK

Other names 1

  • CHANHASSEN CENTER DRUG Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453420800000",
    "number": "1891807897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 HUNDERTMARK RD",
            "address_2": "SUITE 100",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553184551",
            "telephone_number": "952-949-1002",
            "fax_number": "952-949-0233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HUNDERTMARK RD STE 100",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553181194",
            "telephone_number": "952-949-1002",
            "fax_number": "952-949-0233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANHASSEN CENTER DRUG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2016-01-22",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "RPH",
        "authorized_official_telephone_number": "952-949-1002"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "2625522",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "099560600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2046933",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHANHASSEN CENTER DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chaska, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2016; 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.