GOODRICH PHARMACY, INC. (NPI# 1174635171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174635171 |
| Entity Type | Organization |
| Organization Name | GOODRICH PHARMACY, INC. |
| Other Organization Name | GOODRICH PHARMACY ELK RIVER |
| Practice Address |
530 3rd St Nw Elk River MN 55330-1445 |
| Mailing Address |
601 Jacob Ln Anoka MN 55303-1776 |
| Practice Telephone | 7634410764 |
| Practice Fax Number | 7635874897 |
| Mailing Telephone | 7634410764 |
| Mailing Fax Number | 7635874897 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-06-08 |
| Authorized Official Name | STEPHANIE MARIE DAVIS (OWNER) |
| Authorized Official Telephone | 7634215540 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
265080 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 606360800 | 05 | |
| PK | 2046716 | 01 |
| Other Name | Type Code |
|---|---|
| GOODRICH PHARMACY ELK RIVER | Doing Business As Name - Organization |
| Street Address |
530 3RD ST NW |
| City | ELK RIVER |
| State | MN |
| Zip Code | 55330-1445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285638221 | William Andrew Wimmer | Pharmacist | 530 3rd St Nw, Elk River, MN 55330-1445 | 2005-06-08 |
| 1063727733 | Benjamin Robert Kinderman | Chiropractor | 530 3rd St Nw, Elk River, MN 55330-1445 | 2010-08-18 |
| 1144548769 | Lauren Ashley Kinderman | Chiropractor | 530 3rd St Nw, Elk River, MN 55330-1445 | 2010-05-06 |
| 1053571109 | Kate M. Sann | Family Medicine | 530 3rd St Nw, Riverway Clinic-elk River-mail Stop 39400a, Elk River, MN 55330-8863 | 2008-06-12 |
| 1598956559 | Jennifer Marie Brown | Family Medicine | 530 3rd St Nw, Elk River, MN 55330 | 2007-08-06 |
| 1558422469 | Group Health Plan Inc | Durable Medical Equipment & Medical Supplies | 530 3rd St Nw, Suite 101, Elk River, MN 55330 | 2006-12-13 |
| 1528028677 | Donelle Lynn King | Nurse Practitioner | 530 3rd St Nw, Elk River, MN 55330 | 2006-03-24 |
| 1265409569 | Charles Burton Erickson | Family Medicine | 530 3rd St Nw, Mail Stop 39400a, Elk River, MN 55330-1445 | 2006-03-06 |
| 1750358586 | Chi-chi Nwasinachukwu Phina Ayika | Obstetrics & Gynecology | 530 3rd St Nw, Mail Stop 39400a, Elk River, MN 55330-1445 | 2006-03-01 |
| 1982670956 | Jenny E Enstrom | Physician Assistant | 530 3rd St Nw, Mail Stop 39400a, Elk River, MN 55330 | 2006-02-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710504139 | Jacob Stevens | Pharmacist | 19216 Freeport Ave, Cub Pharmacy, Elk River, MN 55330 | 2020-07-01 |
| 1578187456 | Coborns Inc | Pharmacy | 15700 88th St Ne, Otsego, MN 55330 | 2020-06-05 |
| 1346888609 | Katie Eberley | Counselor | 9425 Quantrelle Ave, Otsego, MN 55330 | 2019-12-18 |
| 1649839986 | Jodi Marie Pikula | Massage Therapist | 710 Dodge Ave, Suite C, Elk River, MN 55330 | 2019-06-11 |
| 1144793878 | Northern Cities Therapy, Inc. | Counselor | 19230 Evans St Nw Ste 100, Elk River, MN 55330 | 2019-01-04 |
| 1144715236 | Jennifer Kay Dahlseid | Chiropractor | 200 5th St Nw Ste J, Elk River, MN 55330 | 2018-06-29 |
| 1124542089 | Megan Majsterski Lazere | Counselor | 9245 Quantrelle Avenue, Otsego, MN 55330 | 2017-08-01 |
| 1134674237 | Rescare Minnesota | Community Based Residential Treatment Facility, Mental Illness | 633 Upland Ave Nw, Elk River, MN 55330 | 2016-08-18 |
| 1356894927 | Allison Benz | Counselor | 9245 Quantrelle Ave, Otsego, MN 55330 | 2016-07-29 |
| 1447615141 | Laura Stevenson | Speech-Language Pathologist | 15990 90th St., Otsego, MN 55330 | 2015-12-22 |
| Find all providers in zip 55330 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Clinic Pharmacy |
| A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083138317 | Fairview Pharmacy Services LLC | Pharmacy | 17 Exchange St W Ste 150, Saint Paul, MN 55102-1045 | 2017-07-28 |
| 1760792691 | Goodrich Pharmacy Fridley | Pharmacy | 480 Osborne Rd Suite 180, Fridley, MN 55432 | 2010-10-13 |
| 1770719585 | Fairview Pharmacy Services LLC | Pharmacy | 14712 Victor Hugo Blvd N Ste 10, Hugo, MN 55038-6324 | 2009-06-08 |
| 1548400849 | Moka Pharmacy Inc | Pharmacy | 1515 E Franklin Ave, Minneapolis, MN 55404-2137 | 2009-02-26 |
| 1902012107 | Metro Treatment of Minnesota, Lp | Pharmacy | 14 E Central Entrance, Suite B, Duluth, MN 55811-5508 | 2007-05-15 |
| 1790909083 | Aitkin Community Hospital Inc. | Pharmacy | 27278 State Hwy 18, Garrison, MN 56450 | 2007-04-11 |
| 1437203882 | Shakopee Mdewakanton Sioux Comm Phcy | Pharmacy | 15045 Mystic Lake Dr Nw, Prior Lake, MN 55372-9011 | 2007-01-23 |
| 1407931553 | Waconia Pharmacy | Pharmacy | 430 Highway 5 West, Waconia, MN 55387-1795 | 2006-10-26 |
| 1548365406 | Mayo Foundation for Medical Education & Research | Pharmacy | 201 Center St W, Ste Lo92, Rochester, MN 55902-3003 | 2006-09-14 |
| 1407951353 | Mayo Foundation for Medical Education & Research | Pharmacy | 221 4th Ave Sw Ste 1116, Rochester, MN 55902-3110 | 2006-09-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.