institution
Columbia Park Medical Group, Pa
Clinic Pharmacy in Andover, Minnesota
NPI 1417056698

Columbia Park Medical Group, Pa is a Clinic Pharmacy based in Fridley, MN and is specialized in Clinic Pharmacy. Columbia Park Medical Group, Pa practices in Andover, MN. The NPI Number for Columbia Park Medical Group, Pa is 1417056698 and holds a License No. 261566-8 (Minnesota).

The current practice location address for Columbia Park Medical Group, Pa is 13819 Hanson Blvd Nw, Andover, MN and can be reached out via phone at 763-862-4445 and via fax at 763-862-4465.

Location: 13819 Hanson Blvd Nw, Andover, MN, 55432-4341
institution
Provider Profile Details
NPI Number
1417056698
Provider Name
Columbia Park Medical Group, Pa
Credential
Provider Entity Type
Organization
Address
13819 Hanson Blvd Nw, Andover, MN, 55432-4341
Phone Number
763-862-4445
Fax Number
763-862-4465
Provider Enumeration Date
09/22/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
306066 01 MN ANDA
45Q12CO 01 MN BCBS DME NUMBER
10016952 01 MN IPC NUMBER
24-22917 01 MN NABP NUMBER
314420 01 MN MCKESSON
institution
Provider Business Practice Location Address Details
Address
13819 Hanson Blvd Nw
City
State
Zip
55304-7608
Phone Number
763-862-4445
Fax Number
763-862-4465
person
Provider Business Mailing Address Details
Address
13819 Hanson Blvd Nw
City
State
Zip
55304-7608
Phone Number
763-862-4445
Fax Number
763-862-4465
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Pharmacy
Speciality
Clinic Pharmacy
Taxonomy
License No.
261566-8 (Minnesota)
Definition
A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.
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