Moon's Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MOON'S PHARMACY

Practice address

17 Main St S
Blackduck, MN 56630

Phone

(218) 835-7740

Fax

(218) 835-7869

NPI assigned

Jun 18, 2006

Last updated

Sep 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joseph Moon

Title

Owner

Phone

(218) 835-7740

Specialties & licenses 2

Addresses

Other identifiers 1

Tax ID family

Moon's Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Tam of Blackduck PA

  dba Moons Pharmacy

  • Community/Retail Pharmacy
  • Blackduck, MN
  • NPI 1073657011
  NPD tax ID

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1720023252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 280",
            "city": "BLACKDUCK",
            "state": "MN",
            "postal_code": "566300280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 MAIN ST S",
            "city": "BLACKDUCK",
            "state": "MN",
            "postal_code": "56630",
            "telephone_number": "218-835-7740",
            "fax_number": "218-835-7869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOON'S PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-835-7740"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MN",
            "license": "2604093",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2403652",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Dilley
• Michelle Furuseth, OTR/L
• Jenna Gross, NP
• Elaine D Kelly, PA-C
• Scott Joseph Larson, D.D.S
• Colleen Notsch
• Thomas K O'Reilly, D.C.
• Sanford Clinic North (Sanford Bemidji Blackduck Clinic)
• Sanford Health of Northern Minnesota (Sanford Blackduck Pharmacy)
• Sanford Health of Northern Minnesota (Sanford Blackduck Pharmacy)

• Community/Retail Pharmacy in Blackduck, MN
• Providers in Blackduck, MN by specialty
• Community/Retail Pharmacy in Minnesota

• 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.

Verify at the official NPI Registry.