LTC PRESCRIPTION PROVIDERS #2 (NPI# 1720541337) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720541337 |
| Entity Type | Organization |
| Organization Name | LTC PRESCRIPTION PROVIDERS #2 |
| Practice Address |
220 1/2 Third Avenue Proctor MN 55810 |
| Practice Telephone | 2186289369 |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2019-06-11 |
| Authorized Official Name | DOUGLAS WHITE (OFFICER) |
| Authorized Official Telephone | 2186289368 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MINNESOTA PHARMACY LICENSE | 265809 | 01 |
| Street Address |
220 1/2 THIRD AVENUE |
| City | PROCTOR |
| State | MN |
| Zip Code | 55810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164757282 | Angela Marie Swanstrom | Registered Nurse | 9238 Meadow Street, Duluth, MN 55810 | 2009-10-07 |
| 1154584027 | Golden Oaks Advanced Assisted Living Plus - Proctor | Assisted Living Facility | 23 Waterview Dr, Proctor, MN 55810 | 2008-07-09 |
| 1285739490 | David Lawrence Bopp | Dentist | 225 Second St, Proctor, MN 55810 | 2006-09-13 |
| 1538571831 | Jessica M Downs | Registered Nurse | 4815 Burning Tree Rd, Duluth, MN 55810 | 2014-05-21 |
| 1245628742 | Andrea Mckay | Specialist/Technologist | 1226 2nd Ave, Proctor, MN 55810-1218 | 2015-01-06 |
| 1194002816 | Anita Caines | Dental Hygienist | 8104 Vinland St, Duluth, MN 55810-1402 | 2011-11-09 |
| 1619350436 | Rolen Cares, LLC | Nursing Care | 204 3rd Ave, Duluth, MN 55810-1617 | 2015-06-30 |
| 1962571810 | Ltc Prescription Providers Inc | Pharmacy | 220 3rd Ave, Proctor, MN 55810-1617 | 2006-11-07 |
| 1083012165 | Fcsl Proctor, LLC | Assisted Living Facility | 913 Old Highway 2, Proctor, MN 55810-1750 | 2014-12-05 |
| 1609274794 | Fcsl Proctor, LLC | Assisted Living Facility | 919 Old Highway 2, Proctor, MN 55810-1750 | 2014-12-05 |
| Find all providers in zip 55810 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| 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 |
|---|---|---|---|---|
| 1114544822 | Rolseth Drug Co | Pharmacy | 26709 Forest Blvd, Wyoming, MN 55092-8022 | 2020-06-29 |
| 1962037242 | United Community Pharmacy Corporation | Pharmacy | 2500 Highway 88 Ste 105, St Anthony, MN 55418-4138 | 2020-03-07 |
| 1629613005 | Lotus Ltc Pharmacy, LLC | Pharmacy | 9850 51st Ave N Ste 102, Plymouth, MN 55442-3271 | 2019-11-09 |
| 1639634710 | Lewis Family Drug, LLC | Pharmacy | 1105 13th Ave S, Saint James, MN 56081 | 2019-02-04 |
| 1033680046 | Brainerd Medical Center Inc | Pharmacy | 280 Barclay Ave W, Ste 1100, Pine River, MN 56474 | 2018-12-17 |
| 1457832909 | Black Forest Pharmacy Services Ltd | Pharmacy | 108 S 6th St Ste 1, Brainerd, MN 56401-3594 | 2018-08-23 |
| 1467932905 | Watertown Pharmacy LLC | Pharmacy | 204 Lewis Ave S Ste 101, Watertown, MN 55388-4501 | 2018-08-15 |
| 1942702394 | Polaris Pharmacy Services of Minnesota, LLC | Pharmacy | 4220 Park Glen Road, St. Louis Park, MN 55416 | 2018-03-01 |
| 1346757457 | Twin Valley Pharmacy LLC | Pharmacy | 108 Viking Ave W., Ulen, MN 56585 | 2018-01-10 |
| 1548708175 | Lewis Family Drug, LLC | Pharmacy | 1095 Morgan St, Tracy, MN 56175-1211 | 2017-02-02 |
| 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.