Gordy'S Pharmacy Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2613068 Issued in MN

Legal business name

GORDY'S PHARMACY INC.

Practice address

320 Summit Ave
Center City, MN 55012

Phone

(651) 257-4500

NPI assigned

Nov 2, 2007

Organization subpart

No

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

Authorized official

Name

Mr. William F Garrison, RPHNPI 1013949965

Title

Owner

Phone

(651) 257-4500

Specialties & licenses 1

Addresses

Other identifiers 3

Practitioners 1

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

• William F Garrison, RPH

  • Pharmacist
  • Center City, MN
  • NPI 1013949965
  NPD (past) Authorized official

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1972782290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 127",
            "address_2": "320 SUMMIT AVE",
            "city": "CENTER CITY",
            "state": "MN",
            "postal_code": "550120127",
            "telephone_number": "651-257-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 SUMMIT AVE",
            "city": "CENTER CITY",
            "state": "MN",
            "postal_code": "55012",
            "telephone_number": "651-257-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDY'S PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-02",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "GARRISON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-257-4500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "2613068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2613066",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "2410316",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE TAX ID",
            "identifier": "5359541",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dara Mari Friesen, LICSW
• Ann Boyle Gademsky, MA LADC
• William F Garrison, RPH
• Margaret Gerty
• Sara Jean Giachino, M.A.
• Nikia M Gustafson, MSE, LPCC, LADC
• Annalyse Haagenson
• Christian Robert Samuel Haak, MA, LADC.
• Patricia Ann Hall, MA, CLC
• Philip A Hanson, PH.D

• Community/Retail Pharmacy in Center City, MN
• Providers in Center City, 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 7, 2023; 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.