Provider Demographics
NPI:1083635270
Name:CI PHARMACY SERVICES LTD
Entity Type:Organization
Organization Name:CI PHARMACY SERVICES LTD
Other - Org Name:GUIDEPOINT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/VP
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZWALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-829-0347
Mailing Address - Street 1:108 S 6TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-3575
Mailing Address - Country:US
Mailing Address - Phone:218-829-0347
Mailing Address - Fax:218-829-4701
Practice Address - Street 1:20 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CROSBY
Practice Address - State:MN
Practice Address - Zip Code:56441-1422
Practice Address - Country:US
Practice Address - Phone:218-546-5144
Practice Address - Fax:218-546-7238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
MN2637343336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1083635270Medicaid
MN951262400Medicaid
2420925OtherNCPDP PROVIDER IDENTIFICATION NUMBER