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General NPI Number Information
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NPI Number | 1982924288
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Entity Type | Organization
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Legal Business Name | UNITED COMMUNITY PHARMACY CORPORATION
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Dates
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Enumeration Date | 06/09/2010
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Last Update Date | 03/07/2020
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Provider Practice Location Address
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Address Line | 2500 NEW BRIGHTON BLVD. SUITE 105
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City | SAINT ANTHONY
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State | MN
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Zip | 55418
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Country | US
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Telephone | 612-259-8275
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Fax | 612-259-8286
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Provider Business Mailing Address
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Address Line | 800 BOONE AVE N SUITE 200
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City | GOLDEN VALLEY
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State | MN
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Zip | 55427-4468
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Country | US
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Telephone | 763-417-8888
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Fax | 763-417-9999
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Authorized Official
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Title or Position | CEO
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Name | MARK OLSHANSKY
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Credential |
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Telephone | 612-990-5246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 263509
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License Number State | MN
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