Merwin Broadway Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2624523 Issued in MN

Legal business name

MERWIN BROADWAY PHARMACY

Practice address

700 W Broadway Ave
Minneapolis, MN 55411-2612

Phone

(612) 522-3608

Fax

(612) 522-0091

NPI assigned

Aug 10, 2006

Organization subpart

No

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

Authorized official

Name

Michael Millar

Title

Pharmacist

Phone

(612) 522-3608

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262217600000",
    "number": "1992716401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W BROADWAY AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554112612",
            "telephone_number": "612-522-3608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W BROADWAY AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554112612",
            "telephone_number": "612-522-3608",
            "fax_number": "612-522-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERWIN BROADWAY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2009-12-31",
        "status": "A",
        "authorized_official_last_name": "MILLAR",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "612-522-3608"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "2624523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "744442700",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "2402650",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyson Curtis Merrill, DDS
• Martha Jane Merriman, MA LP LMFT
• Lani Merritt, LICSW
• Jan Delaine Mershon, M.S.
• Tammy Lee Mertens, PA-C
• Kenneth Michael Merwin, MS, RN, BSN, PHN
• Irene Merz
• Roxana Merz, MD
• Mesa, LLC
• Noah Mesa, DMD

• 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 Dec 31, 2009; 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.