GERITOM MED INC NPI 1285621193

NPI Information

NPI: 1285621193
Provider Name: GERITOM MED INC

Doing Business As: GERITOM MED INC

Classification: Pharmacy - 3336L0003X
Entity Type: Organization

Specialization: Long Term Care Pharmacy

Address:
10501 FLORIDA AVE S
BLOOMINGTON, MN
ZIP 55438
Phone: (952) 854-1190
Get Directions

GERITOM MED INC is a long term care pharmacy pharmacy in Bloomington, MN. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. GERITOM MED INC NPI is 1285621193. The provider is registered as an organization entity type.
The provider Is Doing Business As Geritom Med Inc.

The provider's business location address is:

10501 FLORIDA AVE S
BLOOMINGTON, MN
ZIP 55438-553
Phone: (952) 854-1190
Fax: (952) 854-1082

The provider's authorized official is Jason Ryan Wachtl .
The authorized official title is Vice President and has the following contact phone number (952) 854-1190.

The CLIA number assigned to this NPI record is 24D2184031 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/5/2005 and was last updated on 9/16/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332B00000X	Durable Medical Equipment & Medical Supplies				No
2	3336C0003X	Pharmacy	Community/Retail Pharmacy			No
3	333600000X	Pharmacy				No
4	3336L0003X	Pharmacy	Long Term Care Pharmacy	261375	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	718560000	MEDICAID	MINNESOTA
2	2046914	OTHER		PK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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