Essentia Health Detroit Lakes Pharmacy

LBN: St Mary'S Innovis Health
Essentia Health Detroit Lakes Pharmacy is an health care organization with primary practice located at 211 Frazee Street East , Detroit Lakes MN 56501. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Clinic Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. St Mary'S Innovis Health can be contacted via phone (218) 847-3537, or through Hurley, Alan via phone (701) 364-7667.

Contact Information

Primary practice address
211 Frazee Street East Detroit Lakes MN 56501
Phone: (218) 847-3537
Fax: (218) 847-4405
Website:
Map and Directions
Authorized official contact:
Name: Hurley, Alan
Phone: (701) 364-7667

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X 263266 Minnesota
Suppliers / Clinic Pharmacy 3336C0002X 263266 Minnesota
Suppliers / Community/Retail Pharmacy 3336C0003X 263266 Minnesota
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1730110115
LBN Legal business name St Mary'S Innovis Health
DBA Doing business as Essentia Health Detroit Lakes Pharmacy
Authorized official Hurley, Alan
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 5th, 2006
Last updated Jul 3rd, 2024 - about last year

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 1730110115 NPPES
Minnesota Other 2409995 NABP NUMBER
Minnesota MEDICAID 290678000 NABP NUMBER

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