United Community Pharmacy Corporation

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

263509 Issued in MN

Legal business name

UNITED COMMUNITY PHARMACY CORPORATION

Practice address

2500 New Brighton Blvd.
Suite 105
Saint Anthony, MN 55418

Phone

(612) 259-8275

Fax

(612) 259-8286

NPI assigned

Jun 9, 2010

Organization subpart

No

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

Authorized official

Name

Mark Olshansky

Title

Ceo

Phone

(612) 990-5246

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• United Community Pharmacy Corporation Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• United Community Pharmacy Corporation

  • Long Term Care Pharmacy
  • St Anthony, MN
  • NPI 1962037242

  O20231218000143

  Same enrollment

Tax ID family

United Community Pharmacy Corporation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• United Community Pharmacy Corporation

  • Durable Medical Equipment & Medical Supplies
  • Saint Anthony, MN
  • NPI 1588530604
  NPD tax ID
• United Community Pharmacy Corporation

  • Long Term Care Pharmacy
  • St Anthony, MN
  • NPI 1962037242
  NPD tax ID

Locations

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

{
    "created_epoch": "1276041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583539200000",
    "number": "1982924288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BOONE AVE N",
            "address_2": "SUITE 200",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274468",
            "telephone_number": "763-417-8888",
            "fax_number": "763-417-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NEW BRIGHTON BLVD.",
            "address_2": "SUITE 105",
            "city": "SAINT ANTHONY",
            "state": "MN",
            "postal_code": "55418",
            "telephone_number": "612-259-8275",
            "fax_number": "612-259-8286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED COMMUNITY PHARMACY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-09",
        "last_updated": "2020-03-07",
        "certification_date": "2020-03-07",
        "status": "A",
        "authorized_official_last_name": "OLSHANSKY",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-990-5246"
    },
    "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": "263509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2125382",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "715415000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "United Community Pharmacy Corporation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Saint Anthony, MN
• Community/Retail Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.