NPIMap

Lakewood Health System

Organization Active NPI Community/Retail Pharmacy · Pillager, MN

NPI 1396519906 · NPPES record last updated Jun 9, 2025

Key facts

NPI
1396519906
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
Legal business name
LAKEWOOD HEALTH SYSTEM
Practice address
653 Pillsbury St N Ste 2
Pillager, MN 56473-2543
Phone
(218) 746-4321
Fax
(218) 746-4316
NPI assigned
Nov 14, 2023
Organization subpart
Yes
Parent organization (as reported)
LAKEWOOD HEALTH SYSTEM

Authorized official

Name
Joseph Reycraft
Title
Cfo
Phone
(218) 894-8194

Owned or controlled facilities with NPI records 3

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

Other NPIs on the same Medicare enrollment 2

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

Other NPIs with the same Medicare PAC ID 14

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

Corporate family (same tax ID) 13

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

Practitioners 161

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 161

Laboratory certificates & supplier records

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Lakewood Health System
653 Pillsbury St N, Pillager, MN 56473-2543 · (218) 746-4321		 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignment
Participating since Jan 1, 1997

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MN

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Lakewood Clinic
Staples, MN · CCN 243422		 Rural health clinic 5% Or Greater Direct Ownership Interest
General Partnership Interest		 Apr 1, 1997
Apr 1, 1997
Lakewood Clinic-Browerville
Eagle Bend, MN · CCN 243421		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1997
Lakewood Clinic-Pillager
Pillager, MN · CCN 243436		 Rural health clinic 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Mar 1, 1998
Mar 1, 1998

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20231219001166 MN DME Supplier - Pharmacy 1052229671 Practice locations: Pillager, MN
O20231228001019 MN Part B Supplier - Pharmacy 1052229671 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pillager, MN; Staples, MN

National Provider Directory

Tax ID family
Lakewood Clinic Staples (14 organizations share this tax ID)
Part of
Lakewood Clinic Staples

Locations

333 Gillis Ave S
Browerville, MN 56438
Phone (320) 594-2231

221 Lake St S
Ste 102
Long Prairie, MN 56347
Phone (320) 732-3051

653 Pillsbury St N
#1
Pillager, MN 56473
Phone (218) 746-4550

2251 Connecticut Ave S
Ste 3800
Sartell, MN 56377
Phone (320) 252-3376

1210 US 10 E
Ste 1
Staples, MN 56479
Phone (218) 894-2242

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Yes
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

653 Pillsbury St N Ste 2
Pillager, MN 56473-2543

Mailing address

49725 County 83
Staples, MN 56479-5280
Phone (218) 894-1515

Other identifiers

IdentifierTypeStateIssuer
266846OtherMNSTATE LICENSE

Other names

  • Longbella Drug by Lakewood Health System - Pillager Clinic Doing business as

Other providers in Pillager, MN

All providers in Pillager, MN · Community/Retail Pharmacy in Minnesota

Sources for this page

Verify at the official NPI Registry.