GOODRICH PHARMACY INC (NPI# 1619089612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619089612 |
| Entity Type | Organization |
| Organization Name | GOODRICH PHARMACY INC |
| Other Organization Name | GOODRICH PHARMACY ANDOVER |
| Practice Address |
15245 Bluebird St Nw Andover MN 55304-3538 |
| Mailing Address |
601 Jacob Ln Anoka MN 55303-1776 |
| Practice Telephone | 7634341901 |
| Practice Fax Number | 7635874694 |
| Mailing Telephone | 7634214766 |
| Mailing Fax Number | 7634219229 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2016-07-05 |
| Authorized Official Name | SCOTT BENSON (OWNER) |
| Authorized Official Telephone | 7634341901 |
| 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 |
265079 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 781019900 | 05 | |
| PK | 2047848 | 01 |
| Other Name | Type Code |
|---|---|
| GOODRICH PHARMACY ANDOVER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346244274 | Goodrich Pharmacy Inc | Pharmacy | 601 Jacob Ln, Anoka, MN 55303-1776 | 2005-06-09 |
| 1891706305 | Goodrich Pharmacy Inc | Pharmacy | 23122 Saint Francis Blvd Nw, Saint Francis, MN 55070-9807 | 2006-08-10 |
| Street Address |
15245 BLUEBIRD ST NW |
| City | ANDOVER |
| State | MN |
| Zip Code | 55304-3538 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396720553 | Scott M Benson II | Pharmacist | 15245 Bluebird St Nw, Andover, MN 55304-3538 | 2005-12-09 |
| 1750941324 | Kari Standfuss | Nurse Practitioner | 15245 Bluebird St Nw, Andover, MN 55304-3538 | 2019-06-17 |
| 1003368929 | Divina Fama Bikeri | Nurse Practitioner | 15245 Bluebird St Nw, Andover, MN 55304-3538 | 2016-10-26 |
| 1336540848 | Raechel Grace Baker | Physician Assistant | 15245 Bluebird St Nw, Andover, MN 55304-3538 | 2014-09-16 |
| 1053729558 | Kamrie Ann Parrott | Nurse Practitioner | 15245 Bluebird St Nw, Andover, MN 55304 | 2014-07-28 |
| 1427367093 | Zacharia G Ogwang | Nurse Practitioner | 15245 Bluebird St Nw, Riverway Urgent Care - Andover, Andover, MN 55304-3554 | 2010-09-30 |
| 1427375849 | Patricia Herbert | Family Medicine | 15245 Bluebird St Nw, Andover, MN 55304-3538 | 2010-04-25 |
| 1376775437 | Lisa Ann Bishop | Pediatrics | 15245 Bluebird St Nw, Andover, MN 55304 | 2009-08-21 |
| 1659522332 | Annette Marie Schmidt | Pharmacist | 15245 Bluebird St Nw, Andover, MN 55304-3538 | 2008-10-01 |
| 1831366079 | Claire A Michael Saad | Family Medicine | 15245 Bluebird St Nw, Riverway Clinic-andover, Andover, MN 55304-3554 | 2008-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114402211 | Sarah Sue Anderson | Speech-Language Pathologist | 1891 Station Pkwy, Andover, MN 55304 | 2018-09-25 |
| 1306354329 | Jennifer Lynn Larkey I | Counselor | 1875 Station Parkway N.w. Andover, Mn 55304, Andover, MN 55304 | 2018-01-11 |
| 1124544895 | Msp Dentistry Inc | Preferred Provider Organization | 13650 Hanson Blvd., Suite #110, Andover, MN 55304 | 2017-08-15 |
| 1912427931 | Brooke Nicole Halliday | Counselor | 1875 Station Pkwy Ne, Andover, MN 55304 | 2017-06-21 |
| 1700286903 | Jari Welle, Inc. | Marriage & Family Therapist | 1328 Mckay Drive Ne, Suite 100, Ham Lake, MN 55304 | 2014-08-26 |
| 1356765192 | Cherrywood Advanced Living, LLC | Assisted Living Facility | 1889 139th Ave Nw, Andover, MN 55304 | 2014-02-14 |
| 1326462177 | Cherrywood Advanced Living, LLC | Assisted Living Facility | 1899 139th Ave Nw, Andover, MN 55304 | 2014-02-14 |
| 1740619568 | Delores Weikle | Physical Therapist | 14531 Jay St, Andover, MN 55304 | 2013-11-02 |
| 1730527003 | Darkou Care Services | Home Health | 14297 Zilla Street Nw, Andover, MN 55304 | 2013-06-10 |
| 1770927758 | Arbor Oaks Senior Living | Assisted Living Facility | 1640 155th Lane Nw, Andover, MN 55304 | 2013-04-22 |
| Find all providers in zip 55304 | ||||
| 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 |
|---|---|---|---|---|
| 1205904034 | Henry J Gialanella Associates Inc | Pharmacy | 4 Lenape Rd, Andover, NJ 07821-4568 | 2006-12-01 |
| 1427157726 | Grand St Paul Cvs LLC | Pharmacy | 3633 Bunker Lake Blvd Nw, Andover, MN 55304-7402 | 2006-09-22 |
| 1033218482 | Cvs Pharmacy Inc | Pharmacy | 68 Main St, Andover, MA 01810-3846 | 2006-09-22 |
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|---|---|---|---|---|
| 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 |
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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.