LAKE ELMO PHARMACY (NPI# 1710012646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710012646 |
| Entity Type | Organization |
| Organization Name | LAKE ELMO PHARMACY |
| Practice Address |
11240 Stillwater Blvd N Lake Elmo MN 55042-9640 |
| Practice Telephone | 6517730889 |
| Mailing Telephone | 6517730889 |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. NICHOLAS R RICH (PHARMACIST) |
| Authorized Official Telephone | 6517730889 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 2611044 | MN | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | NABP NUMBER | 2419275 | 01 |
| Street Address |
11240 STILLWATER BLVD N |
| City | LAKE ELMO |
| State | MN |
| Zip Code | 55042-9640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891885000 | St Croix Valley Dental Pllc | Dentist | 11240 Stillwater Blvd N, Lake Elmo, MN 55128 | 2006-10-16 |
| 1205356573 | Grace Medical Inc. | Durable Medical Equipment & Medical Supplies | 11240 Stillwater Blvd N, Lake Elmo, MN 55042-9321 | 2017-06-27 |
| 1710317417 | Dental Specialists of Minnesota, Pllc | Dentist | 11240 Stillwater Blvd N, Lake Elmo, MN 55042-9321 | 2013-11-15 |
| 1639509334 | Pdg, P.a. | Clinic/Center | 11240 Stillwater Blvd N, Lake Elmo, MN 55042-9321 | 2013-11-15 |
| 1174703649 | Rich Apothecary Inc | Pharmacy | 11240 Stillwater Blvd N, Lake Elmo, MN 55042-9321 | 2007-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811440738 | Eleni Voltidi | Dentist | 8650 Hudson Blvd N Ste 105, Lake Elmo, MN 55042 | 2016-07-27 |
| 1760781314 | Swedehill Lifecare, LLC | Home Health | 8951 Highway 5, Lake Elmo, MN 55042 | 2011-03-22 |
| 1295859676 | St Croix Valley Dental Pllc | Dentist | 10035 City Walk Dr, Ste A Lake Elmo Dental, Lake Elmo, MN 55042 | 2007-03-19 |
| 1245281823 | Kent Gregory Brockmann | Psychiatry & Neurology | 8673 Eagle Point Blvd, Lake Elmo, MN 55042 | 2006-05-16 |
| 1396722674 | Nancy L Johnson-rauen | Physical Therapist | 9242 Hudson Blvd N Ste 400, Lake Elmo, MN 55042 | 2005-12-28 |
| 1639655384 | Katlyn Arndt | Psychiatry & Neurology | 8515 Eagle Point Blvd, Lake Elmo, MN 55042 | 2018-07-16 |
| 1295227247 | Orthodontic Specialists of Minnesota, P.l.l.c. | Dentist | 8650 Hudson Blvd N Ste 105, Lake Elmo, MN 55042 | 2018-06-05 |
| 1396120473 | Pdg, Pa | Clinic/Center | 8650 Hudson Blvd N, Suite 105, Lake Elmo, MN 55042 | 2015-07-30 |
| 1124455324 | Leslie Markowitz | Psychologist | 8550 Hudson Blvd N, Lake Elmo, MN 55042 | 2013-10-02 |
| 1215295001 | Jessica R Baltz | Marriage & Family Therapist | 3819 Laverne Ave N, Lake Elmo, MN 55042 | 2012-04-30 |
| Find all providers in zip 55042 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114442555 | Hope Chang | Pharmacist | 858 Julep Ave N, Lake Elmo, MN 55042-9317 | 2017-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588265649 | Candace Louise Haugtvedt | Pharmacist | 321 Us-10 West, Detroit Lakes, MN 56501 | 2020-11-05 |
| 1295334217 | Mary Jane Andersen | Pharmacist | 3300 Hwy 210 W, Fergus Falls, MN 56537 | 2020-10-21 |
| 1679172522 | Cari Michelle Labonne | Pharmacist | 4202 Creekwood Pl, Hermantown, MN 55811-3692 | 2020-10-21 |
| 1073112983 | Katie Sue Fairchild | Pharmacist | 2301 E Frontage Rd, Litchfield, MN 55355 | 2020-10-21 |
| 1609475615 | Blaine Perry Ecker | Pharmacist | 3300 Highway 210 W., 3300 Highway 210 West, Fergus Falls, MN 56537 | 2020-10-21 |
| 1619576626 | Jessica Margaret Dulli | Pharmacist | 5241 Lincoln Dr Apt 204, Edina, MN 55436-2702 | 2020-10-21 |
| 1649879875 | Dale Rudolph | Pharmacist | 320 22nd Ave Ne, Waseca, MN 56093-2670 | 2020-10-19 |
| 1134728520 | Herve Bertrand Kengne Mbakam | Pharmacist | 1800 Windsor Dr S, Shakopee, MN 55379-8073 | 2020-10-18 |
| 1821696402 | Leah Fischer | Pharmacist | 817 11th St N, New Ulm, MN 56073-1374 | 2020-10-15 |
| 1003414780 | Loren Leroy Carver | Pharmacist | 424 3rd St N, Stillwater, MN 55082-4836 | 2020-10-14 |
| 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.