NPIMap

Organization Active NPI

White Drug Enterprises Inc

Doing business as White Drug #107

  • Community/Retail Pharmacy
  • Cloquet, MN
National Provider Identifier
1053400655
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
260292 Issued in MN
Legal business name
WHITE DRUG ENTERPRISES INC
Doing business as
White Drug #107
Practice address
707 Highway 33 S Ste 12
Cloquet, MN 55720-2665
Phone
(218) 879-6768
Fax
(218) 879-5313
NPI assigned
Oct 12, 2006
Last updated
Jul 31, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Anne Brader
Title
Cfo
Phone
(763) 513-4300

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X
Durable Medical Equipment & Medical Supplies 332B00000X 424-43 WI
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 260292 MN Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

707 Highway 33 S Ste 12
Cloquet, MN 55720-2665

Mailing address

6701 Evenstad Dr N Ste 100
Maple Grove, MN 55369-6013
Phone (763) 513-4300

Other identifiers 3

IdentifierTypeStateIssuer
574857700MedicaidMN
000021271WHMedicaidND
2045738OtherPK

Other names 1

  • WHITE DRUG #107 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031111000219 MN Part B Supplier - Mass Immunization (Roster Biller Only) 8921911801 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Alexandria, MN; Cloquet, MN; Detroit Lakes, MN; Perham, MN; Virginia, MN; Willmar, MN
O20100930076897 MN DME Supplier - Pharmacy 8921911801 Practice locations: Cloquet, MN

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 15

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
White Drug #107707 Highway 33 S, Cloquet, MN 55720-2665(218) 879-6768 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Orthoses: Off-The-Shelf|Ostomy Supplies|Surgical Dressings Accepts assignmentParticipating since May 6, 2011

National Provider Directory

National Provider Directory
Tax ID family
Thrifty White Pharmacy 10317 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

6701 Evenstad Dr N
Ste 100
Maple Grove, MN 55369
Phone (763) 513-4300

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785456000000",
    "number": "1053400655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 EVENSTAD DR N STE 100",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553696013",
            "telephone_number": "763-513-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 HIGHWAY 33 S STE 12",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557202665",
            "telephone_number": "218-879-6768",
            "fax_number": "218-879-5313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE DRUG ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A",
        "authorized_official_last_name": "BRADER",
        "authorized_official_first_name": "ANNE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "763-513-4300"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WI",
            "license": "424-43",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "260292",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "574857700",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000021271WH",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2045738",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WHITE DRUG #107",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WHITE DRUG #107",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cloquet, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.