NPIMap

Organization Active NPI

International Falls Memorial Hospital Association

Doing business as Rainy Lake Pharmacy

  • Pharmacy
  • International Falls, MN
National Provider Identifier
1275284374
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
INTERNATIONAL FALLS MEMORIAL HOSPITAL ASSOCIATION
Doing business as
Rainy Lake Pharmacy
Practice address
314 3Rd St
International Falls, MN 56649-2309
Phone
(218) 283-3061
Fax
(218) 520-3042
NPI assigned
Jan 11, 2022
Last updated
Nov 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Authorized official

Name
Robert Pastor
Title
Ceo
Phone
(218) 283-5488

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU Primary
Community/Retail Pharmacy 3336C0003X NU

Addresses

Primary practice location

314 3Rd St
International Falls, MN 56649-2309

Mailing address

314 3Rd St
International Falls, MN 56649-2309
Phone (218) 283-3061

Other names 1

  • Rainy Lake Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20220330000754 MN Part B Supplier - Pharmacy 1951365998 Practice locations: International Falls, MN
O20231213003755 MN DME Supplier - Pharmacy 1951365998 Practice locations: International Falls, MN
O20240124001562 MN Part B Supplier - Mass Immunization (Roster Biller Only) 1951365998 Practice locations: International Falls, MN

Other NPIs with the same Medicare PAC ID 3

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

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
Rainy Lake Pharmacy314 3Rd St, International Falls, MN 56649-2309(218) 283-3061 Nebulizer Drugs Accepts assignmentParticipating since Jan 1, 1991

National Provider Directory

National Provider Directory
Tax ID family
Falls Mem Hosp5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

314 3rd St
International Falls, MN 56649
Phone (218) 283-3061

4540 Lake St
Orr, MN 55771
Phone (218) 757-3288

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Littlefork Care CenterLittlefork, MN, CCN 245542 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Apr 1, 2016
Oct 23, 2025
Rainy Lake Medical CenterInternational Falls, MN, CCN 243469 Rural health clinic Operational/Managerial Control (100%) Aug 21, 2013

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 58

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.

View all 58

NPI Registry JSON

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699401600000",
    "number": "1275284374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 3RD ST",
            "city": "INTERNATIONAL FALLS",
            "state": "MN",
            "postal_code": "566492309",
            "telephone_number": "218-283-3061",
            "fax_number": "218-520-3042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 3RD ST",
            "city": "INTERNATIONAL FALLS",
            "state": "MN",
            "postal_code": "566492309",
            "telephone_number": "218-283-3061",
            "fax_number": "218-520-3042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNATIONAL FALLS MEMORIAL HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-11",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A",
        "authorized_official_last_name": "PASTOR",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "218-283-5488"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rainy Lake Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in International Falls, MN

Sources for this page

Verify at the official NPI Registry.