Organization
COLUMBIA PARK MEDICAL GROUP, PA
Active
Other names
CPMG-Andover Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN LOUIS WEIR (EXECUTIVE DIRECTOR)
(763) 586-5877
Entity
Organization
Contact information
Practice address
13819 HANSON BLVD NW, SUITE 100, ANDOVER, MN 55304-7608
(763) 862-4445
(763) 862-4465
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
261566-8
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10016952
IPC NUMBER
MN
01
—
24-22917
NABP NUMBER
MN
01
—
306066
ANDA
MN
01
—
314420
MCKESSON
MN
01
—
45Q12CO
BCBS DME NUMBER
MN
Enumeration date
09/22/2006
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.
Contact us