COLUMBIA PARK MEDICAL GROUP, PA – NPI #1417056698
Pharmacy

A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.

COLUMBIA PARK MEDICAL GROUP, PA is a pharmacy located in ANDOVER, MN. NPPES has assigned the NPI number 1417056698 to COLUMBIA PARK MEDICAL GROUP, PA on September 22, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. COLUMBIA PARK MEDICAL GROUP, PA is also known by the name CPMG-ANDOVER PHARMACY. The primary taxonomy selected by this provider is 3336C0002X from the Health Care Provider Taxonomy code set, which is classified as Pharmacy, specializing in Clinic Pharmacy

The NPI profile was previously updated about 3 years ago on Mar 07, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for COLUMBIA PARK MEDICAL GROUP, PA below.

NPI Profile for
COLUMBIA PARK MEDICAL GROUP, PA

NPI Number
1417056698
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
COLUMBIA PARK MEDICAL GROUP, PA
Other Name: CPMG-ANDOVER PHARMACY
Primary location
13819 HANSON BLVD NW
SUITE 100
ANDOVER, MN 55304-7608
Phone: (763) 862-4445 Fax: (763) 862-4465
Mailing address
6401 UNIVERSITY AVE NE
FRIDLEY, MN 55432-4341
Phone: (763) 572-5710 Fax: (763) 571-3008
Organization Subpart
No
Authorized Official
JOHN WEIR
EXECUTIVE DIRECTOR
Phone: (763) 586-5877
Updated
Identifiers

Identifiers for COLUMBIA PARK MEDICAL GROUP, PA

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

See identifiers
DescriptionIssuerStateIdentifier
otherANDAMN306066
otherBCBS DME NUMBERMN45Q12CO
otherIPC NUMBERMN10016952
otherMCKESSONMN314420
otherNABP NUMBERMN24-22917
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
3336C0002X
- Pharmacy / Clinic Pharmacy (Primary)
MN 261566-8

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.