SHAKOPEE MDEWAKANTON SIOUX COMM PHCY (NPI# 1437203882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437203882 |
| Entity Type | Organization |
| Organization Name | SHAKOPEE MDEWAKANTON SIOUX COMM PHCY |
| Other Organization Name | SMSC PHARMACY |
| Practice Address |
15045 Mystic Lake Dr Nw Prior Lake MN 55372-9011 |
| Practice Telephone | 9522332900 |
| Practice Fax Number | 9522338066 |
| Mailing Telephone | 9522332900 |
| Mailing Fax Number | 9522338066 |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2016-03-31 |
| Authorized Official Name | WILLIAM WEIERS (PHARMACY DIRECTOR) |
| Authorized Official Telephone | 9522332900 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | 262982 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2049180 | 01 |
| Other Name | Type Code |
|---|---|
| SMSC PHARMACY | Doing Business As Name - Organization |
| Street Address |
15045 MYSTIC LAKE DR NW |
| City | PRIOR LAKE |
| State | MN |
| Zip Code | 55372-9011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477944437 | Matthew Steven Pivec | Pharmacist | 15045 Mystic Lake Dr Nw, Prior Lake, MN 55372-9011 | 2015-02-12 |
| 1598156531 | William J. Weiers | Pharmacist | 15045 Mystic Lake Dr Nw, Prior Lake, MN 55372-9011 | 2015-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043830995 | Abby Lynn Quinnell | Physician Assistant | 19455 Towering Oaks Trl, Prior Lake, MN 55372 | 2020-04-21 |
| 1659914547 | Touching Lives Community, Inc. | Assisted Living Facility | 5554 Woodside Road, Se, Prior Lake, MN 55372 | 2019-10-23 |
| 1366961542 | Doreen Lubi Isubikalu | Family Medicine | 2330 Sioux Trail Nw, Prior Lake, MN 55372 | 2017-09-19 |
| 1760909519 | Terese Marie Sovis | Massage Therapist | 15140 Green Oaks Trail, Prior Lake, MN 55372 | 2017-08-23 |
| 1689805301 | Laura Grace Patton | Physician Assistant | 4151 Willowwood Street Se, Prior Lake, MN 55372 | 2009-07-29 |
| 1952582702 | Lilah Suzan Ekim Dds, Ms. Pllc | Dentist | 16190 Erie Ave Se, Prior Lake, MN 55372 | 2007-11-21 |
| 1679618326 | Basile Orthodontics Pa | Dentist | 5116 Gateway Street Se #103, Suite #103, Prior Lake, MN 55372 | 2007-02-20 |
| 1700890134 | Shakopee Mdewakanton Emergency Services | Ambulance | 2525 Flandreau Trail, Prior Lake, MN 55372 | 2006-07-28 |
| 1548299167 | Darlene Merchant | Psychologist | 15815 Franklin Trail S.e., Suite 308 Darlene Merchant, M.a., L.p., Prior Lake, MN 55372 | 2006-07-03 |
| 1508806530 | Kelly Brooks | Nurse Anesthetist, Certified Registered | 3564 Willow Beach St Sw, Prior Lake, MN 55372 | 2006-06-07 |
| Find all providers in zip 55372 | ||||
| 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 |
|---|---|---|---|---|
| 1952495350 | Snyders Drug | Pharmacy | 5101 Gateway St Se, Prior Lake, MN 55372-2049 | 2006-10-03 |
| 1639477854 | Fairview Pharmacy Services LLC | Pharmacy | 4151 Willowwood St Se, Prior Lake, MN 55372-4304 | 2011-03-11 |
| 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 | ||||
| City | PRIOR LAKE |
| Zip Code | 55372 |
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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.