Active NPI
Family Health Systems of Moose Lake Inc
Doing business as Family Pharmacy
- Clinic Pharmacy
- Moose Lake, MN
National Provider Identifier
1407887599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic Pharmacy
- License
- 2608565
- Legal business name
- FAMILY HEALTH SYSTEMS OF MOOSE LAKE INC
- Doing business as
- Family Pharmacy
- Practice address
- 4570 County Hwy 61
Moose Lake, MN 55767-9419 - Phone
- (218) 485-2111
- Fax
- (218) 485-8256
- NPI assigned
- Jul 6, 2006
- Last updated
- Sep 11, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Bill Storck
- Title
- Coo
- Phone
- (217) 485-5671
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic Pharmacy | 3336C0002X | 2608565 | MN | Primary |
| Community/Retail Pharmacy | 3336C0003X | 2608565 | MN |
Addresses
Primary practice location
4570 County Hwy 61
Moose Lake, MN 55767-9419
Mailing address
710 South Kenwood Ave
Moose Lake, MN 55767
Phone (218) 485-5671
Other names 1
- Family Pharmacy
National Provider Directory
National Provider Directory- Tax ID family
- Family Health Systems of Moose Lake Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Family Pharmacy Sandstone
- Clinic Pharmacy
- Sandstone, MN
- NPI 1073544151
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1407887599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 SOUTH KENWOOD AVE",
"city": "MOOSE LAKE",
"state": "MN",
"postal_code": "55767",
"telephone_number": "218-485-5671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4570 COUNTY HWY 61",
"city": "MOOSE LAKE",
"state": "MN",
"postal_code": "557679419",
"telephone_number": "218-485-2111",
"fax_number": "218-485-8256"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY HEALTH SYSTEMS OF MOOSE LAKE INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-06",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "STORCK",
"authorized_official_first_name": "BILL",
"authorized_official_title_or_position": "COO",
"authorized_official_telephone_number": "217-485-5671",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "3336C0002X",
"taxonomy_group": "",
"desc": "Pharmacy, Clinic Pharmacy",
"state": "MN",
"license": "2608565",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "MN",
"license": "2608565",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Family Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Moose Lake, MN
- Essentia Health Moose Lake
- Essentia Health Moose Lake (Essentia Health Moose Lake Clinic)
- Essentia Health Moose Lake (Essentia Health Moose Lake Home Care)
- Essentia Health Moose Lake (Essentia Health Moose Lake (Swing Bed))
- Family Chiropractic Care Inc.
- Katharine Ann Finifrock, RN
- Lynn Marie Folsted, PT
- Amy Jo Forbes, PT
- Jennifer S Gangelhoff, OTR/L
- Gateway Family Health Clinic, LTD.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.