WATERTOWN PHARMACY LLC (NPI# 1467932905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467932905 |
| Entity Type | Organization |
| Organization Name | WATERTOWN PHARMACY LLC |
| Practice Address |
204 Lewis Ave S Ste 101 Watertown MN 55388-4501 |
| Practice Telephone | 9529552153 |
| Practice Fax Number | 9529553067 |
| Mailing Telephone | 9529552153 |
| Mailing Fax Number | 9529553067 |
| Enumeration Date | 2018-08-15 |
| Last Update Date | 2018-08-15 |
| Authorized Official Name | ROSEMARY LOUISE ROSDAHL (OWNER) |
| Authorized Official Telephone | 9529552153 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
261954 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 1720013279 | 05 | |
| MEDICARE | 3929710001 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164770756 | Watertown Pharmacy LLC | Pharmacy | 4689 Shoreline Drive, Suite 100, Spring Park, MN 55384 | 2012-08-29 |
| 1720013279 | Watertown Pharmacy LLC | Pharmacy | 204 Lewis Ave S, Suite 101, Watertown, MN 55388-4500 | 2006-07-12 |
| Street Address |
204 LEWIS AVE S STE 101 |
| City | WATERTOWN |
| State | MN |
| Zip Code | 55388-4501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093367161 | Rebecca Ann Rosdahl | Pharmacist | 204 Lewis Ave S Ste 101, Watertown, MN 55388-4501 | 2019-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356955868 | Todd A Brewer Dds Pllc | Clinic/Center | 603 Jefferson Ave Sw, Watertown, MN 55388 | 2020-09-02 |
| 1598378952 | Patric Burke | Massage Therapist | 409 Territorial Road, Watertown, MN 55388 | 2020-08-26 |
| 1962983932 | Mary Barthel | Physical Therapist | 200 Wesminster Ave. Nw, Watertown, MN 55388 | 2018-08-27 |
| 1154820132 | Winsted Dental Pllc | Dentist | 229 Lewis Avenue South, Watertown, MN 55388 | 2018-02-06 |
| 1134200264 | Heather Marie Kary Jarvis | Chiropractor | 203 Lewis Ave S, Watertown, MN 55388 | 2006-10-17 |
| 1528150174 | Westwood Place | Health Maintenance Organization | 209 Jefferson Ave Sw, Watertown, MN 55388 | 2006-09-29 |
| 1841392107 | Kathleen Mary Mccann | Dentist | 229 Lewis Ave, Watertown, MN 55388 | 2006-09-05 |
| 1710027990 | Chiropractic Specialists of Watertown PC | Chiropractor | 203 Lewis Ave S, Watertown, MN 55388 | 2007-02-07 |
| 1962588525 | Melinda S. Ament | Nurse Practitioner | 204 Lewis Ave S, Watertown, MN 55388 | 2006-10-27 |
| 1740350677 | Robert Thomas Griffith | Dentist | 100 Angel Ave Sw, Watertown, MN 55388-0100 | 2006-11-08 |
| Find all providers in zip 55388 | ||||
| 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 |
|---|---|---|---|---|
| 1699319335 | Boltons Pharmacy Inc | Pharmacy | 128 W Main St, Watertown, NY 13601-1989 | 2019-11-06 |
| 1720013279 | Watertown Pharmacy LLC | Pharmacy | 204 Lewis Ave S, Suite 101, Watertown, MN 55388-4500 | 2006-07-12 |
| 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 |
| 1720541337 | Ltc Prescription Providers #2 | Pharmacy | 220 1/2 Third Avenue, Proctor, MN 55810 | 2019-04-10 |
| 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 |
| 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.