Goodrich Pharmacy Inc
LBN: Goodrich Pharmacy Inc
Goodrich Pharmacy Inc is an health care organization with primary practice located at 2621 Greenhaven Rd Ste 1 , Anoka MN 55303-5566. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Goodrich Pharmacy Inc can be contacted via phone (763) 421-5540, or through Simenson, Steven Thomas via phone (763) 421-5540.
Contact Information
Primary practice address
2621 Greenhaven Rd Ste 1
Anoka MN 55303-5566
Phone: (763) 421-5540
Fax: (763) 421-9229
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | Z008330 | Minnesota |
| Suppliers / Community/Retail Pharmacy | 3336C0003X | ||
| Suppliers / Compounding Pharmacy | 3336C0004X |
Profile Details
| NPI number | 1346244274 |
|---|---|
| LBN Legal business name | Goodrich Pharmacy Inc |
| DBA Doing business as | Goodrich Pharmacy Inc |
| Authorized official | Simenson, Steven Thomas RPH |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 9th, 2005 |
| Last updated | Jul 6th, 2023 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346244274 | NPPES |
| Other | 24D0914028 | CLIA | |
| MEDICAID | 571358700 | CLIA | |
| Other | 0548820001 | CLIA |
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