Corey Todd Malstrom, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

122710 Issued in MN

Practice address

21 W Highway 61
Grand Marais, MN 55604-4401

Phone

(218) 387-1133

Fax

(218) 387-2169

NPI assigned

Jun 27, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• North Shore Pharmacy LTD

  • Pharmacy
  • Grand Marais, MN
  • NPI 1528121308
  NPD (past) Authorized official
• Arrowhead Pharmacy Services, LTD

  • Community/Retail Pharmacy
  • Grand Marais, MN
  • NPI 1205290483
  NPD (past)

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1205287745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 SUMMIT ST APT 337",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558034523",
            "telephone_number": "218-387-1133",
            "fax_number": "844-674-6737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 W HIGHWAY 61",
            "city": "GRAND MARAIS",
            "state": "MN",
            "postal_code": "556044401",
            "telephone_number": "218-387-1133",
            "fax_number": "218-387-2169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALSTROM",
        "first_name": "COREY",
        "middle_name": "TODD",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-27",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "122710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ganna Krevechenko, PHARMD
• Gwen Lawler, LISW
• Rolf E Lindquist, DDS
• Jill Elizabeth Linse, MD
• Brittny Marie Malec, CLD
• Maggie McGowan-Stinski
• Jessi Elizabeth Nicholson, L.AC. MOM
• North Shore Health Therapies, Inc.
• North Shore Pharmacy LTD
• Kelsey Saladin Oneil, DPT

• Pharmacist in Grand Marais, MN
• Providers in Grand Marais, MN by specialty
• Pharmacist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.