CPMG-ANDOVER PHARMACY
NPI 1417056698
Pharmacy - Clinic Pharmacy in Andover, MN

Q: What is Columbia Park Medical Group, PA's NPI number?

The NPI number for Columbia Park Medical Group, PA is 1417056698. It was assigned to this organization in the NPPES registry on September 22, 2006. The provider is also known as Cpmg-Andover Pharmacy.

Q: What is Columbia Park Medical Group, PA's specialty?

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

Active since September 22, 2006

13819 HANSON BLVD NW, SUITE 100, ANDOVER, MN 55304(763) 862-4445(763) 862-4465 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 7, 2023, Aug 22, 2020 (2 updates tracked since 2020).

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About Cpmg-andover Pharmacy NPPES

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

CPMG-ANDOVER PHARMACY (NPI 1417056698) is a healthcare organization registered as a clinic pharmacy in Andover, Minnesota and active in the NPI registry since September 2006. The organization lists John Louis Weir, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1417056698

Entity TypeOrganization

Primary Taxonomy3336C0002X

Legal Business NameCOLUMBIA PARK MEDICAL GROUP, PA

Location Address13819 HANSON BLVD NW, SUITE 100Andover, MN 55304-7608

Mailing Address6401 University Ave NeFridley, MN 55432-4341 · (763) 572-5710 · Fax (763) 571-3008

Phone(763) 862-4445

Fax(763) 862-4465

Organization SubpartNo

Authorized OfficialJohn Louis WeirExecutive Director · (763) 586-5877

Enumeration DateSeptember 22, 2006

Last NPPES UpdateMarch 7, 20232 updates tracked since enumeration

✔ NPI 1417056698 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Clinic PharmacySuppliers

Taxonomy Code3336C0002X

License✔ Licensed in MN · 261566-8

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.

13819 HANSON BLVD NW, Andover, MN 55304

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Other Names 1

Other NameCpmg-andover Pharmacy

Other Identifiers 5

Other306066MN · Anda

Other45Q12COMN · Bcbs Dme Number

Other10016952MN · Ipc Number

Other24-22917MN · Nabp Number

Other314420MN · Mckesson

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.

CHARITO M SANTOS MD

Family Medicine