Individual provider Active NPI

Collin Harris, PHARMD

  • Pharmacist
  • Detroit Lakes, MN
National Provider Identifier
1447863113
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
124285 Issued in MN
Practice address
329 Frazee St E
Detroit Lakes, MN 56501-3603
Phone
(218) 847-1484
Fax
(218) 847-1486
NPI assigned
Aug 24, 2020
Last updated
Dec 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 124285 MN Primary

Addresses

Primary practice location

329 Frazee St E
Detroit Lakes, MN 56501-3603

Mailing address

329 Frazee St E
Detroit Lakes, MN 56501-3603
Phone (218) 847-1484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
124285MNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Grand St Paul CVS LLC PastSince Dec 21, 2021 Accepting new patients
Grand St Paul CVS LLC PastSince Dec 21, 2021 Accepting new patients
Walgreen Co PastSince Apr 10, 2022 Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1447863113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 FRAZEE ST E",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013603",
            "telephone_number": "218-847-1484",
            "fax_number": "218-847-1486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 FRAZEE ST E",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013603",
            "telephone_number": "218-847-1484",
            "fax_number": "218-847-1486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "COLLIN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-24",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "124285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit Lakes, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.