Waconia Clinic Pharmacy

LBN: Legacy Apothecary
Waconia Clinic Pharmacy is an health care organization with primary practice located at 430 W Highway 5 , Waconia MN 55387-1723. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Legacy Apothecary can be contacted via phone (952) 442-3274, or through Loegering, Ryan via phone (651) 334-7322.

Contact Information

Primary practice address
430 W Highway 5 Waconia MN 55387-1723
Phone: (952) 442-3274
Fax: (952) 442-3284
Website:
Map and Directions
Authorized official contact:
Name: Loegering, Ryan PHARMD
Phone: (651) 334-7322

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 264872 Minnesota
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1669837530
LBN Legal business name Legacy Apothecary
DBA Doing business as Waconia Clinic Pharmacy
Authorized official Loegering, Ryan PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Dec 21st, 2015
Last updated Jan 8th, 2019 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669837530 NPPES
Other 2155597 PK
MEDICAID 617666200 PK

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