Grand Itasca Pharmacy

LBN: Grand Itasca Clinic And Hospital
Grand Itasca Pharmacy is an health care organization with primary practice located at 1601 Golf Course Rd , Grand Rapids MN 55744-8648. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Grand Itasca Clinic And Hospital can be contacted via phone (218) 999-1702, or through Macdonell, Jean via phone (218) 326-3401.

Contact Information

Primary practice address
1601 Golf Course Rd Grand Rapids MN 55744-8648
Phone: (218) 999-1702
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Macdonell, Jean
Phone: (218) 326-3401

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1225441157
LBN Legal business name Grand Itasca Clinic And Hospital
DBA Doing business as Grand Itasca Pharmacy
Authorized official Macdonell, Jean
Entity Organization
Organization subpart 1 Yes
Enumeration date Jun 9th, 2014
Last updated Mar 24th, 2022 - about 2 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 1225441157 NPPES
Minnesota MEDICAID 288995200

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