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NPI Code Detail

MEDICARE: SNYDERS DRUG STORES INC

MEDICARE: SNYDERS DRUG STORES INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy2622729MN
23336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12425228OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588758981
Entity Type Code : Organization
Provider Name (Legal Business Name) : SNYDERS DRUG STORES INC
Provider Business Mailing Address
First Line : 14525 HIGHWAY 7
Second Line :
City : MINNETONKA
State : MN
Zip : 55345-3734
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1221 E FRANKLIN AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55404-2923
Country : US
Telephone Number : 612-879-8969
Fax Number : 612-872-8965
Authorized Official
Title or Position : DIRECTOR
Name : JODI RISTAU
Credential :
Telephone Number : 952-936-2404
Provider Enumeration Date : 10/03/2006
Last Update Date : 11/24/2008

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Directions to “SNYDERS DRUG STORES INC ” Practice Location

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