Welia Health
Organization Active NPI Community/Retail Pharmacy · Pine City, MN
NPI 1407276264 · NPPES record last updated Jul 22, 2021
Key facts
- NPI
- 1407276264
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- WELIA HEALTH
- Practice address
- 1425 Main St N
Pine City, MN 55063-6026 - Phone
- (320) 322-5141
- Fax
- (320) 322-5132
- NPI assigned
- Apr 21, 2014
- Organization subpart
- Yes
- Parent organization (as reported)
- WELIA HEALTH
Authorized official
- Name
- Randy Ulseth
- Title
- Ceo
- Phone
- (320) 679-1212
Parent organization (reported in NPPES) 1
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 2
Member organizations 4
Practitioners 60
-
Matthew Gordon Allen, M.D.
-
David Bidle, MD
-
Tanya Lynn Carlson, AGPCNP
-
Andrew M Clary, D.O.
-
Heidi Sue Deutschlander, RN, CNP
-
Ryan Jon Gaalswyk, M.D.
-
Matthew James Hamiel, CRNA
-
Erika Kay Herges, CNP
-
Jill Herges, NP-C
-
Chad Austin Holien, M.D.
-
Shih-an John Hsieh, M.D.
-
Beth Ann Kempf, NP
-
Shannon Marie Koski, CNP
-
David William Kroll, CRNA
-
Ryan Richard Kroschel, M.D.
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Welia Health Community Pharmacy |
Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211012001873 | MN | Part B Supplier - Mass Immunization (Roster Biller Only) | 6709295496 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Mora, MN; Pine City, MN |
| O20211026001126 | MN | DME Supplier - Pharmacy | 6709295496 | Practice locations: Pine City, MN |
National Provider Directory
- Tax ID family
- Welia Health
- Part of
- Welia Health
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Yes |
Addresses
Primary practice location
1425 Main St N
Pine City, MN 55063-6026
Mailing address
1425 Main St N
Pine City, MN 55063-6026
Phone (320) 322-5141
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2144876 | Other | PK | |
| 356680100 | Medicaid | MN |
Other names
- Welia Health Community Pharmacy
Other providers in Pine City, MN
- Wal-Mart Stores, Inc.
- Walker Eldercare Services Inc.
- Walmart Inc.
- Waxberg Clinic PA
- Jessica Juel Weidert
- Welia Health
- Kevin John Westerberg
- Billi J White
- Janice L Williams-Graff
- Crystal Lee Williams
All providers in Pine City, MN · Community/Retail Pharmacy in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.