NPIMap

Organization Active NPI

Prairiestone Pharmacy LLC

Doing business as Dailymed Pharmacy

  • Pharmacist
  • Eden Prairie, MN
National Provider Identifier
1952431884
Registry record updated Jul 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
262983 Issued in MN
Legal business name
PRAIRIESTONE PHARMACY LLC
Doing business as
Dailymed Pharmacy
Practice address
9995 W 69TH St
Ste 102
Eden Prairie, MN 55344-3457
Phone
(952) 656-5095
Fax
(952) 656-5096
NPI assigned
Mar 7, 2007
Organization subpart
Yes
Parent organization
ARCADIA RESOURCES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 1, 2011

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

Authorized official

Name
Matthew Middendorf
Title
Cfo, Secretary, Treasurer
Phone
(317) 569-8234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 262983 MN Primary

Addresses

Primary practice location

9995 W 69TH St
Ste 102
Eden Prairie, MN 55344-3457

Mailing address

PO Box 9830
Salt Lake City, UT 84109-9830
Phone (800) 973-1955

Other identifiers 1

IdentifierTypeStateIssuer
778630000MedicaidMN

Other names 1

  • DAILYMED PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dailymed Pharmacy4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

9995 W 69th St
Ste 102
Eden Prairie, MN 55344
Phone (952) 656-5095

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309478400000",
    "number": "1952431884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9830",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841099830",
            "telephone_number": "800-973-1955",
            "fax_number": "317-575-6195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9995 W 69TH ST",
            "address_2": "STE 102",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443457",
            "telephone_number": "952-656-5095",
            "fax_number": "952-656-5096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIESTONE PHARMACY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARCADIA RESOURCES INC",
        "enumeration_date": "2007-03-07",
        "last_updated": "2011-07-01",
        "status": "A",
        "authorized_official_last_name": "MIDDENDORF",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CFO, SECRETARY, TREASURER",
        "authorized_official_telephone_number": "317-569-8234"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "262983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "778630000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DAILYMED PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eden Prairie, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2011; 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.