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Organization Active NPI

Mille Lacs Health System

Doing business as MLHS Community Pharmacy

  • Community/Retail Pharmacy
  • Onamia, MN
National Provider Identifier
1841947801
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
MILLE LACS HEALTH SYSTEM
Doing business as
MLHS Community Pharmacy
Practice address
200 Elm St N
Onamia, MN 56359-7901
Phone
(320) 532-2492
Fax
(320) 532-2499
NPI assigned
Mar 9, 2022
Last updated
Mar 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Authorized official

Name
William Royce Nelson
Title
Ceo
Phone
(320) 532-2580

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary
Long Term Care Pharmacy 3336L0003X NU

Addresses

Primary practice location

200 Elm St N
Onamia, MN 56359-7901

Mailing address

200 Elm St N
Onamia, MN 56359-7901
Phone (320) 532-2492

Other identifiers 1

IdentifierTypeStateIssuer
266492OtherMNMINNESOTA BOARD OF PHARMACY

Other names 1

  • MLHS Community Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220707002124 MN Part B Supplier - Pharmacy 4789577834 Practice locations: Onamia, MN
O20221215001020 MN DME Supplier - Pharmacy 4789577834 Practice locations: Onamia, MN

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
MLHS Geropsychiatric Unit9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

450 5th St SW
Ste 100
Milaca, MN 56353
Phone (320) 983-2728

416 Main St
Onamia, MN 56359
Phone (320) 532-4127

701 1st St
Princeton, MN 55371
Phone (763) 389-0416

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Cura of OnamiaOnamia, MN, CCN 245127 Skilled nursing facility Adp of the SNF Jul 22, 2002
Mille Lacs Health SystemOnamia, MN, CCN 241588 Hospice Operational/Managerial Control Jun 17, 2009
Mille Lacs Health SystemIsle, MN, CCN 243975 Rural health clinic Operational/Managerial Control Sep 10, 2008
Mille Lacs Health SystemOnamia, MN, CCN 243976 Rural health clinic Operational/Managerial Control Sep 9, 2008

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 205

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 205

NPI Registry JSON

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

{
    "created_epoch": "1646784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710288000000",
    "number": "1841947801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 ELM ST N",
            "city": "ONAMIA",
            "state": "MN",
            "postal_code": "563597901",
            "telephone_number": "320-532-2492",
            "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": "320-532-2492",
            "fax_number": "320-532-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLE LACS HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-09",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "ROYCE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "320-532-2580"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA BOARD OF PHARMACY",
            "identifier": "266492",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MLHS Community Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Onamia, MN

Sources for this page

Verify at the official NPI Registry.