Active NPI
Alex Hauke, PHARMD
- Pharmacist
- Detroit Lakes, MN
National Provider Identifier
1972190940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 124777
- Practice address
- 329 Frazee St E
Detroit Lakes, MN 56501-3603 - Phone
- (218) 847-1484
- Fax
- (218) 847-1486
- NPI assigned
- Dec 24, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 124777 | MN | Primary |
Addresses
Primary practice location
329 Frazee St E
Detroit Lakes, MN 56501-3603
Mailing address
238 Stone Creek Dr Apt 211
Detroit Lakes, MN 56501-6991
Phone (906) 399-1388
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 124777 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grand St Paul CVS LLC | Past | Accepting new patients | |
| Grand St Paul CVS LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608768000000",
"number": "1972190940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "238 STONE CREEK DR APT 211",
"city": "DETROIT LAKES",
"state": "MN",
"postal_code": "565016991",
"telephone_number": "906-399-1388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "329 FRAZEE ST E",
"city": "DETROIT LAKES",
"state": "MN",
"postal_code": "565013603",
"telephone_number": "218-847-1484",
"fax_number": "218-847-1486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAUKE",
"first_name": "ALEX",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-24",
"last_updated": "2020-12-24",
"certification_date": "2020-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "124777",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit Lakes, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.