NPIMap

Organization Active NPI

Northern Pines Medical Center

  • Pharmacy
  • Aurora, MN
National Provider Identifier
1871651646
Registry record updated Oct 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
NORTHERN PINES MEDICAL CENTER
Practice address
5211 Hwy 110
Aurora, MN 55705
Phone
(218) 229-2211
Fax
(218) 229-2042
NPI assigned
Dec 5, 2006
Last updated
Oct 7, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2010

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

Authorized official

Name
Laura Jane Ackman
Title
Ceo
Phone
(218) 229-2211

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU Primary
Long Term Care Pharmacy 3336L0003X NU

Addresses

Primary practice location

5211 Hwy 110
Aurora, MN 55705

Mailing address

5211 Hwy 110
Aurora, MN 55705
Phone (218) 229-2211

Other identifiers 1

IdentifierTypeStateIssuer
173347800MedicaidMN

Other names 1

  • White Community Hospital Corporation Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Northern Pines Medical Ctr4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286409600000",
    "number": "1871651646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5211 HWY 110",
            "city": "AURORA",
            "state": "MN",
            "postal_code": "55705",
            "telephone_number": "218-229-2211",
            "fax_number": "218-229-2042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5211 HWY 110",
            "city": "AURORA",
            "state": "MN",
            "postal_code": "55705",
            "telephone_number": "218-229-2211",
            "fax_number": "218-229-2042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN PINES MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2010-10-07",
        "status": "A",
        "authorized_official_last_name": "ACKMAN",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "218-229-2211"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "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": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173347800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "White Community Hospital Corporation",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Aurora, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2010; 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.