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GOODRICH PHARMACY ELK RIVER
NPI 1174635171
Pharmacy - Clinic Pharmacy in Elk River, MN

Active since August 31, 2006CLIA Certified · 2 labs
530 3RD ST NW, ELK RIVER, MN 55330(763) 441-0764(763) 587-4897 Get Directions Write a Review

NPPES record last updated: July 6, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 6, 2023, Jun 8, 2020, Jun 23, 2016 (3 updates tracked since 2016).

About Goodrich Pharmacy Elk River NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GOODRICH PHARMACY ELK RIVER (NPI 1174635171) is a healthcare organization registered as a clinic pharmacy in Elk River, Minnesota and active in the NPI registry since August 2006. The organization holds 2 active CLIA laboratory certificates and lists Stephanie Marie Davis, Owner, as its authorized official.

NPPES Registry Identity

NPI1174635171
Entity TypeOrganization
Primary Taxonomy3336C0002X
Legal Business NameGOODRICH PHARMACY, INC.
Location Address530 3RD ST NWElk River, MN 55330-1445
Mailing Address2621 Greenhaven Rd Ste 1Anoka, MN 55303-5566 · (763) 441-0764 · Fax (763) 587-4897
Phone(763) 441-0764
Fax(763) 587-4897
Organization SubpartNo
Authorized OfficialStephanie Marie DavisOwner · (763) 421-5540
Enumeration DateAugust 31, 2006
Last NPPES UpdateJuly 6, 20233 updates tracked since enumeration
NPPES CertifiedJune 29, 2023
✔ NPI 1174635171 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Clinic PharmacySuppliers
Taxonomy Code3336C0002X
License✔ Licensed in MN · 265080
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.
Also ListedPharmacyTaxonomy 333600000X
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
530 3RD ST NW, Elk River, MN 55330
Open in Google Maps ↗

Other Names 1

Doing Business AsGoodrich Pharmacy Elk River

Other Identifiers 2

Other2046716Pk
Medicaid606360800MN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Anthem Blue Cross and Blue Shield, Antidote Health Plan of Arizona, Inc. and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D2183636

Goodrich Pharmacy · Elk River, MN
Active · expires May 6, 2028
CLIA Number24D2183636
Laboratory TypePharmacy
Certificate Effective DateMay 7, 2026
Certificate Expiration DateMay 6, 2028
Laboratory DirectorNicole Sikorski
Laboratory Phone(763) 441-0764
Laboratory LocationGoodrich Pharmacy530 3rd St, Elk River, MN 55330
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 24D0914028

Goodrich Pharmacy, Inc · Anoka, MN
Active · expires Apr 17, 2028
CLIA Number24D0914028
Laboratory TypePharmacy
Certificate Effective DateApril 18, 2026
Certificate Expiration DateApril 17, 2028
Laboratory DirectorStephanie Davis
Laboratory Phone(763) 421-5540
Laboratory LocationGoodrich Pharmacy, Inc601 Jacob Lane, Anoka, MN 55303
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
25 services25 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
24 services24 patients

Medical Equipment Supplier Medicare DMEPOS

Medicare supplier enrollment and the product categories Goodrich Pharmacy carries, from the Medicare DMEPOS supplier directory.

Goodrich Pharmacy

DMEPOS supplier · Elk River, MNOperated by Goodrich Pharmacy Inc
✔

Accepts Medicare assignment

Goodrich Pharmacy agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20413925
Medicare Participant SinceMay 20, 2020
Supplier Location530 3rd St NWElk River, MN 55330
Phone(763) 441-0764
Supplier Specialties
Certified Other Pharmacy

Medicare Product Categories

Surgical Dressings
Gauze, Elastic bandages, Adhesive tape
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MELISSA CHRISTENSEN FROEHLICH PNP
Nurse Practitioner
530 3RD ST NW
ELK RIVER, MN 55330
Sherburne County (763) 587-4800
DAVID LEE WINEINGER MD
Pediatrics
530 3RD ST NW, MAIL STOP 39400A
ELK RIVER, MN 55330
Sherburne County (763) 712-6000
DR. TERESA KAY GRAY M.D.
Internal Medicine
530 3RD ST NW
ELK RIVER, MN 55330
Sherburne County (763) 587-4800
CHELSEY LAWRENCE NP-C
Family Medicine
530 3RD ST NW
ELK RIVER, MN 55330
Sherburne County (952) 967-7075
CHARLES WILLIAM LAIS MD
Obstetrics & Gynecology
530 3RD ST NW, MAIL STOP 39400A
ELK RIVER, MN 55330
Sherburne County (763) 712-6000
KATE M. SANN M.D.
Family Medicine
530 3RD ST NW, RIVERWAY CLINIC-ELK RIVER-MAIL STOP 39400A
ELK RIVER, MN 55330
Sherburne County (763) 587-4800
DR. BENJAMIN ROBERT KINDERMAN D.C.
Chiropractor
530 3RD ST NW
ELK RIVER, MN 55330
Sherburne County (763) 587-4800
WILLIAM H RABE MD
Pediatrics
530 3RD ST NW
ELK RIVER, MN 55330
Sherburne County (763) 587-4800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Goodrich Pharmacy, Inc.'s NPI number?

The NPI number for Goodrich Pharmacy, Inc. is 1174635171. It was assigned to this organization in the NPPES registry on August 31, 2006. The provider is doing business as Goodrich Pharmacy Elk River.

Where is Goodrich Pharmacy, Inc. located?

Goodrich Pharmacy, Inc. is located at 530 3rd St NW, Elk River, MN 55330. The listed phone number is (763) 441-0764.

What is Goodrich Pharmacy, Inc.'s specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Clinic Pharmacy, with taxonomy code 3336C0002X.

Does Goodrich Pharmacy, Inc. accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Goodrich Pharmacy accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Goodrich Pharmacy, Inc. hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Goodrich Pharmacy, Inc. accept?

Health plans from Alliant Health Plans, Inc., Anthem Blue Cross and Blue Shield, Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Ohio, Inc. and Avera Health Plans and 27 other insurers list Goodrich Pharmacy, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Goodrich Pharmacy, Inc. was last updated on July 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.