DR. MATTHEW THOR LARSON (NPI# 1609134675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609134675 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW THOR LARSON |
| Credential | PHARMD |
| Practice Address |
20 W Main St Crosby MN 56441-1422 |
| Practice Telephone | 2185465144 |
| Practice Fax Number | 2185467238 |
| Mailing Telephone | 2185465144 |
| Mailing Fax Number | 2185467238 |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2012-04-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 120525 | MN | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043534878 | Matthew Golden Larson | Chiropractor | 9316 Carnation Duvall Rd Ne, Carnation, WA 98014-6706 | 2010-03-23 |
| 1417113648 | Matthew J Larson | Driver | 2112 Hoffman Rd, Mankato, MN 56001-5829 | 2008-08-07 |
| 1326002437 | Matthew G. Larson | Social Worker | 24 S 600 E, Ste. 6, Slc, UT 84102 | 2006-04-14 |
| 1346703634 | Matthew Daniel Larson | Student in an Organized Health Care Education/Training Program | 3901 Rainbow Blvd, Kansas City, KS 66160-8500 | 2019-04-12 |
| 1205315108 | Matthew Larson | Physical Therapist | 433 Mendota Rd E, West St Paul, MN 55118-5104 | 2018-08-10 |
| 1316444615 | Matthew Erick Larson | Radiology | 600 Highland Ave, Madison, WI 53792-0001 | 2018-04-12 |
| 1316352834 | Matthew Larson | Optometrist | 3450 Lacey Rd, Downers Grove, IL 60515-5430 | 2014-06-23 |
| 1982941027 | Matthew Larson | Social Worker | 16 12th Ave S, Suite 201, Nampa, ID 83651-3936 | 2013-01-09 |
| 1922353739 | Matthew W Larson | Pharmacist | 23 Slayton Ave, Spencerport, NY 14559-1427 | 2012-07-17 |
| 1710243795 | Matthew H Larson | Counselor | 390 East 100 South, Ephraim, UT 84627 | 2012-04-04 |
| Street Address |
20 W MAIN ST |
| City | CROSBY |
| State | MN |
| Zip Code | 56441-1422 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740839570 | Nicholas Boreen | Pharmacy | 20 W Main St, Crosby, MN 56441-1422 | 2019-09-04 |
| 1386125821 | Ci Pharmacy Services, Ltd | Pharmacy | 20 W Main St, Crosby, MN 56441-1422 | 2018-08-23 |
| 1134621824 | Matthew Doucette | Pharmacy | 20 W Main St, Crosby, MN 56441-1422 | 2018-03-08 |
| 1891159018 | Ci Pharmacy Services, Ltd | Pharmacy | 20 W Main St, Crosby, MN 56441-1422 | 2016-04-13 |
| 1982961975 | Nicole L Puchalla | Pharmacist | 20 W Main St, Crosby, MN 56441-1422 | 2012-04-16 |
| 1083635270 | Ci Pharmacy Services Ltd | Pharmacy | 20 W Main St, Crosby, MN 56441-1422 | 2006-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043381676 | Shannon Marie Smith | Chiropractor | 5 West Main Street, Crosby, MN 56441 | 2006-11-13 |
| 1841207594 | Bruce B Cunningham | Family Medicine | 320 East Main St, Crosby, MN 56441 | 2006-08-02 |
| 1215911391 | Paul R Carey | Family Medicine | 320 East Main Street, Crosby, MN 56441 | 2005-12-02 |
| 1629550975 | Samuel T Feyder | Physician Assistant | 320 East Main Street, Crosby, MN 56441 | 2018-09-04 |
| 1205299385 | Ann E Johnson | Obstetrics & Gynecology | 320 East Main Street, Crosby, MN 56441 | 2016-04-05 |
| 1407238389 | Brian Holmgren | Internal Medicine | 320 East Main Street, Crosby, MN 56441 | 2015-06-26 |
| 1285013367 | Paige Elizabeth Holmgren | Family Medicine | 320 East Main Street, Crosby, MN 56441 | 2015-05-22 |
| 1891182341 | Robert G Johnson | Surgery | 320 East Main Street, Crosby, MN 56441 | 2015-04-22 |
| 1932514320 | Melissa Sueann Dyrdal | Nurse Practitioner | 320 East Main Street, Crosby, MN 56441 | 2014-06-25 |
| 1477973063 | James J Stokman | Orthopaedic Surgery | 320 East Main Street, Crosby, MN 56441 | 2014-04-22 |
| Find all providers in zip 56441 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427609270 | David Michael Porter | Pharmacist | 1930 Topside Ct, Crosby, TX 77532-5004 | 2019-09-24 |
| 1699375618 | Jaquita Larene Montgomery | Pharmacist | 14215 Fm 2100 Rd, Crosby, TX 77532-9152 | 2020-10-28 |
| 1184224404 | Stephanie Kara Chapman | Pharmacist | 14215 Fm 2100 Rd, Crosby, TX 77532-9152 | 2020-10-27 |
| 1538776356 | Jenna Wentzlaff | Pharmacist | 320 E Main St, Crosby, MN 56441-1645 | 2020-09-25 |
| 1811504640 | Shawn Smart | Pharmacist | 320 E Main St, Crosby, MN 56441-1645 | 2020-09-25 |
| 1366798191 | Brittany M Fox | Pharmacist | 320 E Main St, Crosby, MN 56441-1645 | 2012-07-30 |
| 1982961975 | Nicole L Puchalla | Pharmacist | 20 W Main St, Crosby, MN 56441-1422 | 2012-04-16 |
| 1013229665 | Brianne Marie Burmeister | Pharmacist | 320 E Main St, Crosby, MN 56441-1645 | 2010-07-12 |
| 1124343736 | Lashanta Lenelle Bryant | Pharmacist | 14402 Fm 2100 Rd, Crosby, TX 77532-6570 | 2010-04-07 |
| 1770808438 | Raul (none) Banuelos | Pharmacist | 14402 Fm 2100 Rd, Crosby, TX 77532-6570 | 2010-04-06 |
| Find all providers in CROSBY | ||||
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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.