Essentia Health Virginia LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

2608921 Issued in MN

Legal business name

ESSENTIA HEALTH VIRGINIA LLC

Doing business as

Essentia Health Virginia Hospital Pharmacy

Practice address

901 9TH Street North
Virginia, MN 55792

Phone

(218) 749-9414

Fax

(218) 749-9565

NPI assigned

Aug 14, 2006

Last updated

Feb 23, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

ST. MARY'S DULUTH CLINIC HEALTH SYSTEMAs reported in NPPES

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

Authorized official

Name

Tara Marie Parks, PHARMD

Title

Pharmacy Manager

Phone

(218) 749-9414

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• ESSENTIA HEALTH VIRGINIA HOSPITAL PHARMACY Doing business as

Part of

St Mary's Duluth Clinic Health System

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• St. Mary's Duluth Clinic Health System

  dba SMDC Clinical Laboratory

  • Clinical Medical Laboratory
  • Duluth, MN
  • NPI 1326078049

  Member Of

  NPD member

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487808000000",
    "number": "1740293489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 9TH ST N",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557922325",
            "telephone_number": "218-749-9441",
            "fax_number": "218-749-9565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 9TH STREET NORTH",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "55792",
            "telephone_number": "218-749-9414",
            "fax_number": "218-749-9565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSENTIA HEALTH VIRGINIA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. MARY'S DULUTH CLINIC HEALTH SYSTEM",
        "enumeration_date": "2006-08-14",
        "last_updated": "2017-02-23",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "218-749-9414",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MN",
            "license": "2608921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "900019400",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2412118",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ESSENTIA HEALTH VIRGINIA HOSPITAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kara Esler
• Theresa Marie Espinoza
• Essentia Health Virginia LLC
• Essentia Health Virginia LLC
• Essentia Health Virginia LLC (Essentia Health Virginia)
• Essentia Health Virginia, LLC (Essentia Health Virginia)
• Essentia Health Virginia, LLC (Essentia Health Virginia Care Center)
• Katie R Evans, D.P.M.
• Stephanie Lynn Evans
• Kelsey Everson, PT

• Long Term Care Pharmacy in Virginia, MN
• Providers in Virginia, MN by specialty
• Long Term Care Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2017; 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.