Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Organization
COLUMBIA PARK MEDICAL GROUP, PA
Active
Organization
COLUMBIA PARK MEDICAL GROUP, PA
Active
Other names
CPMG-Brooklyn Park Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN LOUIS WEIR (EXECUTIVE DIRECTOR)
(763) 586-5877
Entity
Organization
Contact information
Practice address
10000 ZANE AVE N, SUITE 100, BROOKLYN PARK, MN 55443-1400
(763) 569-6281
(763) 569-6211
Mailing address
6401 UNIVERSITY AVE NE, FRIDLEY, MN 55432-4341
(763) 572-5710
(763) 571-3008
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
262454-9
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02071BR
BCBS DME NUMBER
MN
01
—
076751
ANDA
MN
01
—
10118513
IPC NUMBER
MN
01
—
2426220
NABP NUMBER
MN
01
—
831146
MCKESSON
MN
Enumeration date
09/23/2006
Last updated
03/07/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up