Healthcare Provider Details

I. General information

NPI: 1982924288
Provider Name (Legal Business Name): UNITED COMMUNITY PHARMACY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2010
Last Update Date: 03/07/2020
Certification Date: 03/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 NEW BRIGHTON BLVD. SUITE 105
SAINT ANTHONY MN
55418
US

IV. Provider business mailing address

800 BOONE AVE N SUITE 200
GOLDEN VALLEY MN
55427-4468
US

V. Phone/Fax

Practice location:
  • Phone: 612-259-8275
  • Fax: 612-259-8286
Mailing address:
  • Phone: 763-417-8888
  • Fax: 763-417-9999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number263509
License Number StateMN

VIII. Authorized Official

Name: MARK OLSHANSKY
Title or Position: CEO
Credential:
Phone: 612-990-5246