Beate Gertrud Pelto, RPH
Individual provider Active NPI Pharmacist · Deer River, MN
NPI 1689969404 · NPPES record last updated Sep 16, 2020
Key facts
- NPI
- 1689969404
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 115648 (MN)
- Practice address
- 2 Division St
Deer River, MN 56636-8779 - Phone
- (218) 246-8642
- NPI assigned
- Jun 9, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115648 | MN | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 115648 | MN | Yes |
Addresses
Primary practice location
2 Division St
Deer River, MN 56636-8779
Mailing address
18530 39TH Ave N
Plymouth, MN 55446-2865
Phone (612) 207-9966
Other practice location 1
4175 Vinewood Ln N
Plymouth, MN 55442-2624
Phone (763) 553-1757
Other providers in Deer River, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2020. 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.