Northern Itasca Hospital District
Organization Active NPI Community/Retail Pharmacy · Bigfork, MN
NPI 1487797544 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1487797544
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 261348 (MN)
- Legal business name
- NORTHERN ITASCA HOSPITAL DISTRICT
- Practice address
- 258 Pine Tree Drive
Bigfork, MN 56628-0258 - Phone
- (218) 743-4444
- Fax
- (218) 743-4232
- NPI assigned
- Feb 15, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- NORTHERN ITASCA HOSPITAL DISTRICT
Authorized official
- Name
- Dr. Heather Leigh Bibeau, PHARMD
- Title
- Director of Pharmacy
- Phone
- (218) 743-4444
Practitioners 3
-
Sara Ann Elioff, PHARMD, RPH
-
Keith Conrad Pearson, RPH
-
Paula M Taylor, RPH
National Provider Directory
- Part of
- Northern Itasca Hospital District
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 261348 | MN | Yes |
| Long Term Care Pharmacy | 3336L0003X | 261348 | MN |
Addresses
Primary practice location
258 Pine Tree Drive
Bigfork, MN 56628-0258
Mailing address
PO Box 258
258 Pine Tree Drive
Bigfork, MN 56628-0258
Phone (218) 743-4444
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2613482 | Other | MN | PHARMACY LICENSE |
| 222121700 | Medicaid | MN | |
| 2421840 | Other | MN | NCPDP |
| 2613482 | Other | MN | BOARD OF PHARMACY |
Other names
- Bigfork Valley Pharmacy
Other providers in Bigfork, MN
- Barret J Myers
- Kimberly Robin Newcombe Nelson
- Northern Itasca Hospital District
- Northern Itasca Hospital District
- Northern Itasca Hospital District
- Northern Itasca Hospital District
- Northern Itasca Hospital District
- Northern Itasca Hospital District
- Northern Itasca Hospital District
- Northern Itasca Hospital District
All providers in Bigfork, 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 Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.