Mathieson Enterprises Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2618270 Issued in MN

Legal business name

MATHIESON ENTERPRISES INC

Doing business as

BURCH PHARMACY

Practice address

1942 Hennepin Ave
Minneapolis, MN 55403-3160

Phone

(612) 871-1895

Fax

(612) 871-1080

NPI assigned

Aug 18, 2006

Organization subpart

No

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

Authorized official

Name

Calvin Mathieson

Title

Pres Owner

Phone

(612) 871-1895

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• BURCH PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269475200000",
    "number": "1922112911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1942 HENNEPIN AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033160",
            "telephone_number": "612-871-1895",
            "fax_number": "612-871-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1942 HENNEPIN AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033160",
            "telephone_number": "612-871-1895",
            "fax_number": "612-871-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATHIESON ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2010-03-25",
        "status": "A",
        "authorized_official_last_name": "MATHIESON",
        "authorized_official_first_name": "CALVIN",
        "authorized_official_title_or_position": "PRES OWNER",
        "authorized_official_telephone_number": "612-871-1895"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "2618270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "744418400",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2403195",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BURCH PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Drew David Mathews, CRNA
• Nansy A Mathews, CRNP
• Molly Marie Mathewson, PTA
• Travis Lane Mathias, LICSW
• Wendy L Mathiason, LICSW
• Patrick J Mathieu
• Christine Mathiowetz, PSYD, LP
• Helen K Mathison, MA CCC
• Jessica Mae Mathwig-Olson, LICSW
• Robert Matlock, M.D.

• Community/Retail Pharmacy in Minneapolis, MN
• Providers in Minneapolis, 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 Mar 25, 2010; 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.