MOON'S PHARMACY (NPI# 1720023252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720023252 |
| Entity Type | Organization |
| Organization Name | MOON'S PHARMACY |
| Practice Address |
17 Main St S Blackduck MN 56630 |
| Mailing Address |
Po Box 280 Blackduck MN 56630-0280 |
| Practice Telephone | 2188357740 |
| Practice Fax Number | 2188357869 |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JOSEPH MOON (OWNER) |
| Authorized Official Telephone | 2188357740 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 333600000X | Pharmacy | 2604093 | MN | Suppliers |
| X | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 2403652 | 01 |
| Street Address |
17 MAIN ST S |
| City | BLACKDUCK |
| State | MN |
| Zip Code | 56630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073657011 | Tam of Blackduck Pa | Pharmacy | 17 Main St S, Blackduck, MN 56630-4245 | 2007-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992078802 | American Physicians of Chiropractic Science, Ltd | Chiropractor | 80 West Summit Ave, Blackduck, MN 56630 | 2012-02-23 |
| 1225203359 | Paul Roy Bengtson | Dentist | 49 Summit Ave E, Blackduck, MN 56630 | 2008-04-29 |
| 1275665028 | Thomas K O'reilly | Chiropractor | 80 Summit Ave W, Blackduck, MN 56630 | 2007-03-09 |
| 1003991944 | Blackduck Dental Clinic | Dentist | 49 Summit Ave. Se, Blackduck, MN 56630 | 2006-10-26 |
| 1548342421 | Blackduck Isd #32 | Local Education Agency (LEA) | 156 1st St Ne, Blackduck, MN 56630 | 2006-10-19 |
| 1932212693 | Blackduck Ambulance Association | Ambulance | 55 Railroad Avenue, Blackduck, MN 56630 | 2006-08-16 |
| 1306865423 | Elaine D Kelly | Physician Assistant | 1st Ave W & Margaret St, Blackduck, MN 56630 | 2006-07-19 |
| 1124045125 | Sherry S Billups | Family Medicine | 81 1st St Nw, Blackduck, MN 56630 | 2006-07-16 |
| 1831130921 | Sanford Clinic North | Family Medicine | 81 1st Street Nw, Blackduck, MN 56630 | 2006-06-09 |
| 1497736169 | The Evangelical Lutheran Good Samaritan Society | Durable Medical Equipment & Medical Supplies | 172 Summit Avenue West, Blackduck, MN 56630 | 2005-11-09 |
| Find all providers in zip 56630 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073657011 | Tam of Blackduck Pa | Pharmacy | 17 Main St S, Blackduck, MN 56630-4245 | 2007-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861033276 | Nina Marie Kleinschmidt | Pharmacy | 1315 Minnesota Ave, Detroit Lakes, MN 56501-3913 | 2019-10-07 |
| 1659837698 | Bpoint Pharmacy Services Ltd | Pharmacy | 30833 North Star Dr, Suite 2, Breezy Point, MN 56472 | 2019-02-14 |
| 1477042372 | Sanford Clinic North | Pharmacy | 1611 Anne St Nw Ste 1, Bemidji, MN 56601-5114 | 2018-05-07 |
| 1295222909 | A & E Pharmacy LLC | Pharmacy | 1509 10th Ave S, Minneapolis, MN 55404-1754 | 2018-04-18 |
| 1215445085 | Genoa Healthcare LLC | Pharmacy | 8441 Wayzata Blvd, Suite 340, Golden Valley, MN 55426-1372 | 2018-01-16 |
| 1497279608 | Coborns Inc | Pharmacy | 110 1st St S Ste B, Sauk Rapids, MN 56379-1404 | 2017-07-29 |
| 1740711753 | Hennepin Healthcare System Inc | Pharmacy | 800 Washington Ave N Ste 190, Minneapolis, MN 55401-1330 | 2017-03-22 |
| 1568903532 | First Choice Pharmacy of Jordan PC | Pharmacy | 165 West Commerce Drive, Suite 110, Belle Plaine, MN 56011 | 2017-03-10 |
| 1013454545 | Genesis Recovery Services, LLC | Pharmacy | 5 N 3rd Ave W Ste 302, Duluth, MN 55802-1614 | 2017-01-23 |
| 1104360973 | Group Health Plan, Inc. | Pharmacy | 3800 Park Nicollet Blvd Ste 1170, St Louis Park, MN 55416-2527 | 2016-12-13 |
| 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.