Perham Health Hospital Pharmacy

LBN: Perham Hospital District
Perham Health Hospital Pharmacy is an health care organization with primary practice located at 1000 Coney St W , Perham MN 56573-2102. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Institutional Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Institutional Pharmacy is the primary health care specialty. Perham Hospital District can be contacted via phone (218) 347-1580, or through Wallace, Duane via phone (218) 347-1571.

Contact Information

Primary practice address
1000 Coney St W Perham MN 56573-2102
Phone: (218) 347-1580
Fax: (218) 347-1652
Website:
Map and Directions
Authorized official contact:
Name: Wallace, Duane RPH
Phone: (218) 347-1571

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Institutional Pharmacy 3336I0012X 200303 Minnesota
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1154467678
LBN Legal business name Perham Hospital District
DBA Doing business as Perham Health Hospital Pharmacy
Authorized official Wallace, Duane RPH
Entity Organization
Organization subpart 1 No
Enumeration date Jan 30th, 2007
Last updated Jun 30th, 2014 - about 10 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 1154467678 NPPES
Other 2045652 PK
MEDICAID 211047400 PK

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