Ellie Kosaka
Individual provider Active NPI Pharmacist · Cass Lake, MN
NPI 1104740075 · NPPES record last updated Aug 5, 2026
Key facts
- NPI
- 1104740075
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 4581924 (ID)
- Practice address
- 425 7TH St NW
Cass Lake, MN 56633-3360 - Phone
- (218) 335-3200
- NPI assigned
- Aug 5, 2026
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 4581924 | ID | Yes |
Addresses
Primary practice location
425 7TH St NW
Cass Lake, MN 56633-3360
Mailing address
401 Irvine Ave NW Unit 1053
Bemidji, MN 56619-4048
Phone (909) 208-0532
Other names
- Ellie Lauren Kosaka
Other providers in Cass Lake, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.