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Mille Lacs Health System

Organization Active NPI Institutional Pharmacy · Onamia, MN

NPI 1720163207 · NPPES record last updated Jan 18, 2017

Key facts

NPI
1720163207
Entity type
Organization (NPI type 2)
Primary specialty
Institutional Pharmacy 3336I0012X
License
2010470 (MN)
Legal business name
MILLE LACS HEALTH SYSTEM
Practice address
200 Elm St N
Onamia, MN 56359-7901
Phone
(320) 532-2490
Fax
(320) 532-2499
NPI assigned
Oct 25, 2006
Organization subpart
No

Authorized official

Name
Greg Steffenson
Title
Pharmacist
Phone
(320) 532-2490

Corporate family (same tax ID) 8

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

National Provider Directory

Tax ID family
Mille Lacs Family Clini (9 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X
Institutional Pharmacy 3336I0012X 2010470 MN Yes
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

200 Elm St N
Onamia, MN 56359-7901

Mailing address

PO Box a
Onamia, MN 56359-0807
Phone (320) 532-2490

Other identifiers

IdentifierTypeStateIssuer
2045656OtherPK
190247400MedicaidMN

Other names

  • MILLE LACS HOSPITAL PHARMACY Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 18, 2017.

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1720163207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX A",
            "city": "ONAMIA",
            "state": "MN",
            "postal_code": "563590807",
            "telephone_number": "320-532-2490",
            "fax_number": "320-532-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ELM ST N",
            "city": "ONAMIA",
            "state": "MN",
            "postal_code": "563597901",
            "telephone_number": "320-532-2490",
            "fax_number": "320-532-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLE LACS HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "STEFFENSON",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "320-532-2490"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "MN",
            "license": "2010470",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2045656",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190247400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MILLE LACS HOSPITAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Onamia, MN

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Verify at the official NPI Registry.