NPIMap

Organization Active NPI

Northern Itasca Hospital District

Doing business as Bigfork Valley Pharmacy

  • Community/Retail Pharmacy
  • Bigfork, MN
National Provider Identifier
1659315711
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
261348-2 Issued in MN
Legal business name
NORTHERN ITASCA HOSPITAL DISTRICT
Doing business as
Bigfork Valley Pharmacy
Practice address
258 Pine Tree Drive
Bigfork, MN 56628
Phone
(218) 743-3177
Fax
(218) 743-3559
NPI assigned
Jun 16, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Harold Daniel Odegaard
Title
Ceo
Phone
(218) 743-3177

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 261348-2 MN Primary

Addresses

Primary practice location

258 Pine Tree Drive
Bigfork, MN 56628

Mailing address

258 Pine Tree Drive
P.O. Box 258
Bigfork, MN 56628
Phone (218) 743-3177

Other identifiers 1

IdentifierTypeStateIssuer
2421840OtherMNNABP

Other names 1

  • Bigfork Valley Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northern Itasca Hospital Pharmacy7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659315711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 PINE TREE DRIVE",
            "address_2": "P.O. BOX 258",
            "city": "BIGFORK",
            "state": "MN",
            "postal_code": "56628",
            "telephone_number": "218-743-3177",
            "fax_number": "218-743-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 PINE TREE DRIVE",
            "city": "BIGFORK",
            "state": "MN",
            "postal_code": "56628",
            "telephone_number": "218-743-3177",
            "fax_number": "218-743-3559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN ITASCA HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ODEGAARD",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "218-743-3177",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "261348-2",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "2421840",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bigfork Valley Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bigfork, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.