CENTRACARE PHARMACY SERVICES LLC (NPI# 1386600641) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386600641 |
| Entity Type | Organization |
| Organization Name | CENTRACARE PHARMACY SERVICES LLC |
| Other Organization Name | CENTRACARE PHARMACY NORTHWAY |
| Practice Address |
1555 Northway Dr Ste 150 Saint Cloud MN 56303-4912 |
| Mailing Address |
1555 Northway Dr Suite 150 Saint Cloud MN 56303-4555 |
| Practice Telephone | 3202403160 |
| Practice Fax Number | 3202555876 |
| Mailing Telephone | 3202403160 |
| Mailing Fax Number | 3202555876 |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2016-07-05 |
| Authorized Official Name | KEITH KARSKY (COORDINATOR RETAIL PHARM. SE) |
| Authorized Official Telephone | 3202512700 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
261081 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2047034 | 01 | |
| MN | 649822100 | 05 |
| Other Name | Type Code |
|---|---|
| CENTRACARE PHARMACY NORTHWAY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093771818 | Centracare Pharmacy Services LLC | Pharmacy | 1406 Sixth Avenue North, St Cloud, MN 56303 | 2006-04-21 |
| 1578128021 | Centracare Pharmacy Services LLC | Pharmacy | 1900 Centracare Circle, Suite 1849, St. Cloud, MN 56303 | 2019-05-09 |
| 1013966175 | Centracare Pharmacy Services LLC | Pharmacy | 1900 Centracare Circle, Suite 1350, St Cloud, MN 56303 | 2006-05-08 |
| Street Address |
1555 NORTHWAY DR STE 150 |
| City | SAINT CLOUD |
| State | MN |
| Zip Code | 56303-4912 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800463 | Daniel P Lahr | Radiologic Technologist | St Cloud Va Health Care System, 4801 Veterans Drive, St Cloud, MN 56303 | 2020-08-07 |
| 1730798398 | County of Stearns | Case Management | 705 Courthouse Square, St Cloud, MN 56303 | 2020-07-29 |
| 1669007126 | Aflah Transportation LLC | Non-emergency Medical Transport (VAN) | 3316 3rd Street North, Suite 129, Saint Cloud, MN 56303 | 2020-03-05 |
| 1609420942 | Stephanie Lynne Metzger | Nurse Practitioner | Centracare Clinic Riverc Ampus/nephrology, 1200 Sixth Ave North, St. Cloud, MN 56303 | 2019-07-25 |
| 1306406947 | Willow Tree Acupuncture LLC | Acupuncturist | 203 Cooper Ave N Suite 160, St. Cloud, MN 56303 | 2019-06-17 |
| 1821553520 | Alan Melvin Hoeper | Nurse Anesthetist, Certified Registered | Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 | 2019-02-06 |
| 1437644465 | Brianna Larissa Justin | Speech-Language Pathologist | St. Cloud Hospital, 1406 6th Avenue N, St. Cloud, MN 56303 | 2018-06-22 |
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| 1639682925 | Dereje Beyene | Respiratory Therapist, Certified | 1406 15th Street North, Saint Cloud, MN 56303 | 2017-11-09 |
| 1740792761 | Lisa Ann Horner | Nurse Practitioner | 1555 Northway Drive #110, Centracare Complex Care Clinic, St Cloud, MN 56303 | 2017-10-31 |
| Find all providers in zip 56303 | ||||
| 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 |
|---|---|---|---|---|
| 1487117792 | Costco Wholesale Corporation | Pharmacy | 3636 2nd St S, Saint Cloud, MN 56301-3732 | 2019-04-12 |
| 1235447723 | Walgreen Co | Pharmacy | 251 County Road 120 Ste 101, Saint Cloud, MN 56303-4886 | 2010-09-17 |
| 1396067468 | Coborns Inc | Pharmacy | 250 33rd Ave S, Saint Cloud, MN 56301-6131 | 2010-02-17 |
| 1750485660 | Holiday Cvs LLC | Pharmacy | 2101 13th St, Saint Cloud, FL 34769-4206 | 2006-09-12 |
| 1124122015 | Holiday Cvs LLC | Pharmacy | 3555 13th St, Saint Cloud, FL 34769-4054 | 2006-09-12 |
| 1326053638 | Walgreen Co | Pharmacy | 2505 W Division St, Saint Cloud, MN 56301-3837 | 2006-07-29 |
| 1689696361 | Grand St Paul Cvs LLC | Pharmacy | 4201 W Division St, Saint Cloud, MN 56301-6601 | 2006-07-24 |
| 1861036592 | Keshav Rx LLC | Pharmacy | 520 13th St, Saint Cloud, FL 34769-4531 | 2019-11-06 |
| 1205328663 | St.cloud Pharmacy&wellness Center | Pharmacy | 2801 13th St, Saint Cloud, FL 34769-4134 | 2018-06-01 |
| 1194897868 | Coborns Inc | Pharmacy | 2118 8th St N, Saint Cloud, MN 56303-6150 | 2006-11-15 |
| Find all providers in SAINT CLOUD | ||||
| City | SAINT CLOUD |
| Zip Code | 56303 |
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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.