{"npi":"1386787729","type":"NPI-2","status":"active","name":{"display":"Mattson Pharmacy, INC","other":[],"organization_name":"MATTSON PHARMACY, INC","authorised_official":"Linda Desrosier"},"specialty":{"primary_taxonomy":"3336C0003X","primary_taxonomy_description":"Community/Retail Pharmacy","slug":"community-retail-pharmacy","schema_org_specialty":null,"all":[{"code":"3336L0003X","description":"Long Term Care Pharmacy","primary":false,"state":null,"license":"260108"},{"code":"3336C0004X","description":"Compounding Pharmacy","primary":false,"state":"MN","license":"260108"},{"code":"332B00000X","description":"Durable Medical Equipment & Medical Supplies","primary":false,"state":"MN","license":"260108"},{"code":"3336C0003X","description":"Community/Retail Pharmacy","primary":true,"state":"MN","license":"260108"}]},"addresses":[{"purpose":"LOCATION","street_1":"152 MAIN ST N","city":"GREENBUSH","state":"MN","postal_code":"567264015","country_code":"US","phone":"2187822366","fax":"2187822365"},{"purpose":"MAILING","street_1":"PO BOX 39","city":"GREENBUSH","state":"MN","postal_code":"567260039","country_code":"US","phone":"2187822366","fax":"2187822365"}],"license":{"state":"MN","number":"260108"},"identifiers":[{"type_code":"01","label":"Other","value":"2409604","state":"MN","issuer":"NCPDP NUMBER"},{"type_code":"01","label":"Other","value":"2601083","state":"MN","issuer":"PHARMACY LICENSE"},{"type_code":"05","label":"Medicaid","value":"338257500","state":"MN","issuer":null},{"type_code":"01","label":"Other","value":"6319469","state":"MN","issuer":"MN TAX ID NUMBER"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20100930096986","type_code":"30-A5","type_desc":"DME SUPPLIER - PHARMACY","state":"MN","pac_id":"1850410127"}]},"enumeration_date":"2007-02-15","last_updated":"2023-03-07","_meta":{"source":"NPPES","snapshot_date":"2023-03-07","doc_url":"https://findmynpi.com/api"}}