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MATTSON PHARMACY INC NPI 1386787729


NPI Information

NPI: 1386787729
Provider Name: MATTSON PHARMACY, INC

Doing Business As: GREENBUSH PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 24D2262763

Address:
152 MAIN ST N
GREENBUSH, MN
ZIP 56726
Phone: (218) 782-2366
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MATTSON PHARMACY, INC is a community/retail pharmacy pharmacy in Greenbush, MN. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. MATTSON PHARMACY, INC NPI is 1386787729. The provider is registered as an organization entity type.
The provider Is Doing Business As Greenbush Pharmacy.

The provider's business location address is:

152 MAIN ST N
GREENBUSH, MN
ZIP 56726-015
Phone: (218) 782-2366
Fax: (218) 782-2365

The provider's authorized official is Linda Desrosier .
The authorized official title is Manager and has the following contact phone number (218) 463-2465.

The CLIA number assigned to this NPI record is 24D2262763 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/15/2007 and was last updated on 3/7/2023.


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
13336L0003XPharmacyLong Term Care Pharmacy260108No
23336C0004XPharmacyCompounding Pharmacy260108MINNESOTANo
3332B00000XDurable Medical Equipment & Medical Supplies260108MINNESOTANo
43336C0003XPharmacyCommunity/Retail Pharmacy260108MINNESOTAYes

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
12409604OTHERMINNESOTANCPDP NUMBER
22601083OTHERMINNESOTAPHARMACY LICENSE
3338257500MEDICAIDMINNESOTA
46319469OTHERMINNESOTAMN TAX ID NUMBER

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.