Organization
PARK NICOLLET METHODIST HOSPITAL
Active
Parent organization
PARK NICOLLET PHARMACY
Other names
METHODIST HOSPITAL PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
PARK NICOLLET PHARMACY
Authorized official
JASON JAMES LUHRS (VP FINANCE)
(952) 883-7158
Entity
Organization
Contact information
Practice address
6500 EXCELSIOR BLVD, ST LOUIS PARK, MN 55426-4702
(952) 993-6016
(952) 993-6303
Mailing address
8170 33RD AVE S, MS 21111B, BLOOMINGTON, MN 55425-4516
(952) 993-3804
(952) 967-6667
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336I0012X
Institutional Pharmacy
Primary
200304
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2045768
PK
—
05
—
897017300
—
MN
Enumeration date
07/25/2006
Last updated
08/09/2022
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