MATTSON PHARMACY, INC (NPI# 1346383908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346383908 |
| Entity Type | Organization |
| Organization Name | MATTSON PHARMACY, INC |
| Practice Address |
111 Main Ave S Roseau MN 56751-1421 |
| Practice Telephone | 2184632465 |
| Practice Fax Number | 2184632875 |
| Mailing Telephone | 2184632465 |
| Mailing Fax Number | 2184632875 |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2020-04-02 |
| Authorized Official Name | MRS. LINDA M DESROSIER (MANAGER) |
| Authorized Official Telephone | 2184632465 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
201190 | MN | Suppliers |
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
201190 | MN | Suppliers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 0683560001 | MN | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
201190 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | DEA REGISTRATION NUMBER | AM7913761 | 01 |
| MN | 981858800 | 05 | |
| MN | NCPDP NUMBER | 2407802 | 01 |
| MN | PHARMACY LICENSE | 2011903 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386787729 | Mattson Pharmacy, Inc | Pharmacy | 152 Main St N, Greenbush, MN 56726-4015 | 2007-02-15 |
| Street Address |
111 MAIN AVE S |
| City | ROSEAU |
| State | MN |
| Zip Code | 56751-1421 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811235013 | Sara B Broten | Pharmacist | 111 Main Ave S, Roseau, MN 56751-1421 | 2013-01-22 |
| 1285972547 | Steven Semingson | Pharmacist | 111 Main Ave S, Roseau, MN 56751-1421 | 2013-01-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841739885 | David Simmons | Pharmacist | 715 Delmore Drive, Roseau, MN 56751 | 2017-02-22 |
| 1770841082 | Amber Rohde | Physical Therapist | 44371 350 St., Roseau, MN 56751 | 2012-04-25 |
| 1275632234 | Jack Victor Lundbohm | Chiropractor | 317 2nd St Nw Ste A, Roseau, MN 56751 | 2006-09-22 |
| 1558390336 | Marianne Renae Foldesi | Physician Assistant | 711 Delmore Drive, Roseau, MN 56751 | 2006-07-02 |
| 1871679456 | Roseau/warroad Eye Clinic, P.a. | Optometrist | 306 N Main, Roseau, MN 56751 | 2006-10-27 |
| 1194935619 | Ageless Care,inc | Home Health | 702 7th St Sw, Roseau, MN 56751-0000 | 2007-05-23 |
| 1235176033 | Lorris Galen Vatnsdal II | Dentist | 205a 2nd Ave Nw, Roseau, MN 56751-1007 | 2006-06-01 |
| 1336204536 | Lorris G. Vatnsdal, Ltd. | Dentist | 205a 2nd Ave Nw, Roseau, MN 56751-1007 | 2006-12-27 |
| 1164584322 | Cynthia Faye Drost-sandy | Dentist | 205a 2nd Ave Nw, Roseau, MN 56751-1007 | 2006-12-14 |
| 1952478489 | Robert Frank Larson | Dentist | 201 4th Ave Nw, Roseau, MN 56751-1033 | 2006-11-29 |
| Find all providers in zip 56751 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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 |
|---|---|---|---|---|
| 1497368633 | Sawtooth Mountain Clinic, Inc. | Pharmacy | 513 5th Ave W Rm 201, Grand Marais, MN 55604-3017 | 2020-08-27 |
| 1891313326 | Rochester Community Pharmacy LLC | Pharmacy | 1604 1st St Nw, Rochester, MN 55901-0318 | 2020-07-10 |
| 1134745730 | Elko New Market Family Pharmacy, LLC | Pharmacy | 117 Old Town Road, Elko New Market, MN 55054 | 2020-06-19 |
| 1578187456 | Coborns Inc | Pharmacy | 15700 88th St Ne, Otsego, MN 55330 | 2020-06-05 |
| 1205460169 | Genoa Healthcare, LLC | Pharmacy | 1515 Energy Park Dr Ste 110, Saint Paul, MN 55108-5229 | 2020-02-28 |
| 1801438361 | The Duluth Clinic, Ltd. | Pharmacy | 2 Division St Ste A, Deer River, MN 56636-8779 | 2019-10-16 |
| 1265084792 | Nudak Ventures, LLC | Pharmacy | 5418 Saint Croix Trl, North Branch, MN 55056-4203 | 2019-07-15 |
| 1659938116 | Sterlingrx Inc | Pharmacy | 1312 Northland Dr Ste 500, Mendota Heights, MN 55120-1436 | 2019-05-21 |
| 1639734346 | Seward Pharmacy LLC | Pharmacy | 2209 E Lake St, Minneapolis, MN 55407-4563 | 2019-05-08 |
| 1093370694 | Minnesota Ave N Pharmacy Services Limited | Pharmacy | 226 Minnesota Ave N, Aitkin, MN 56431-1412 | 2019-05-08 |
| 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.