Active NPI
Vernon D Krueger, RPH
- Pharmacist
- Maple Grove, MN
National Provider Identifier
1972556983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 111007
- Practice address
- 12880 Elm Creek Blvd N
Maple Grove, MN 55369-7052 - Phone
- (763) 420-3005
- Fax
- (763) 420-8624
- NPI assigned
- May 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 111007 | MN | Primary |
Addresses
Primary practice location
12880 Elm Creek Blvd N
Maple Grove, MN 55369-7052
Mailing address
3635 Saratoga LN N
Plymouth, MN 55441-2435
Phone (763) 546-0630
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 111007 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lund Food Holdings Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Maple Grove, MN
- NPI 1841375771
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1972556983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3635 SARATOGA LN N",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554412435",
"telephone_number": "763-546-0630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12880 ELM CREEK BLVD N",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553697052",
"telephone_number": "763-420-3005",
"fax_number": "763-420-8624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUEGER",
"first_name": "VERNON",
"middle_name": "D",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-19",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "111007",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maple Grove, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.