FAMILY HEALTH SYSTEMS OF MOOSE LAKE INC (NPI# 1407887599) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407887599 |
| Entity Type | Organization |
| Organization Name | FAMILY HEALTH SYSTEMS OF MOOSE LAKE INC |
| Other Organization Name | FAMILY PHARMACY |
| Practice Address |
4570 County Hwy 61 Moose Lake MN 55767-9419 |
| Mailing Address |
710 South Kenwood Ave Moose Lake MN 55767 |
| Practice Telephone | 2184852111 |
| Practice Fax Number | 2184858256 |
| Mailing Telephone | 2184855671 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. BILL STORCK (COO) |
| Authorized Official Telephone | 2174855671 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
2608565 | MN | Suppliers |
| X | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
2608565 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 28557900 | 05 |
| Other Name | Type Code |
|---|---|
| Family Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073544151 | Family Health Systems of Moose Lake Inc | Pharmacy | 204 Lundorff Dr, Sandstone, MN 55072-5051 | 2006-07-06 |
| Street Address |
4570 COUNTY HWY 61 |
| City | MOOSE LAKE |
| State | MN |
| Zip Code | 55767-9419 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619316031 | Kathleen Marie Madden | Pharmacist | 4570 County Hwy 61, Moose Lake, MN 55767 | 2013-06-19 |
| 1568801090 | Kendra Dawn Metz | Pharmacist | 4570 County Hwy 61, Moose Lake, MN 55767 | 2013-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437778529 | Essentia Health Moose Lake | Home Health | 30 Arrowhead Ln, Moose Lake, MN 55767 | 2020-04-09 |
| 1841775475 | Katherine Mcdowell | Social Worker | 451 Arrowhead Lane, Moose Lake, MN 55767 | 2018-09-28 |
| 1316191786 | Vision Pro | Optometrist | 125 W Arrowhead Rd, Moose Lake, MN 55767 | 2008-11-11 |
| 1265627327 | Dr. Joseph J. Jamros Optometry, Ltd. | Optometrist | 312 Elm Ave., Moose Lake, MN 55767 | 2007-09-12 |
| 1013108075 | Diane Louise Stellrecht | Psychologist | 505 3rd Street, Suite A, Moose Lake, MN 55767 | 2007-08-06 |
| 1073674529 | Downtown Dental Care Pa | Dentist | 304 Elm Ave, Moose Lake, MN 55767 | 2006-12-12 |
| 1760558399 | Joseph John Jamros | Optometrist | 312 Elm Ave, Moose Lake, MN 55767 | 2006-11-27 |
| 1205909991 | Msocs-moose Lake | Intermediate Care Facility, Mentally Retarded | 305 4th St, Moose Lake, MN 55767 | 2006-11-17 |
| 1295804482 | Moose Lake Community Hospital District | Home Health | 30 Arrowhead Lane, Moose Lake, MN 55767 | 2006-11-06 |
| 1396770772 | Sonja M. Roach | Nurse Practitioner | 4570 County Highway 61, Moose Lake, MN 55767 | 2006-07-12 |
| Find all providers in zip 55767 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Clinic Pharmacy |
| A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083138317 | Fairview Pharmacy Services LLC | Pharmacy | 17 Exchange St W Ste 150, Saint Paul, MN 55102-1045 | 2017-07-28 |
| 1760792691 | Goodrich Pharmacy Fridley | Pharmacy | 480 Osborne Rd Suite 180, Fridley, MN 55432 | 2010-10-13 |
| 1770719585 | Fairview Pharmacy Services LLC | Pharmacy | 14712 Victor Hugo Blvd N Ste 10, Hugo, MN 55038-6324 | 2009-06-08 |
| 1548400849 | Moka Pharmacy Inc | Pharmacy | 1515 E Franklin Ave, Minneapolis, MN 55404-2137 | 2009-02-26 |
| 1902012107 | Metro Treatment of Minnesota, Lp | Pharmacy | 14 E Central Entrance, Suite B, Duluth, MN 55811-5508 | 2007-05-15 |
| 1790909083 | Aitkin Community Hospital Inc. | Pharmacy | 27278 State Hwy 18, Garrison, MN 56450 | 2007-04-11 |
| 1437203882 | Shakopee Mdewakanton Sioux Comm Phcy | Pharmacy | 15045 Mystic Lake Dr Nw, Prior Lake, MN 55372-9011 | 2007-01-23 |
| 1407931553 | Waconia Pharmacy | Pharmacy | 430 Highway 5 West, Waconia, MN 55387-1795 | 2006-10-26 |
| 1548365406 | Mayo Foundation for Medical Education & Research | Pharmacy | 201 Center St W, Ste Lo92, Rochester, MN 55902-3003 | 2006-09-14 |
| 1407951353 | Mayo Foundation for Medical Education & Research | Pharmacy | 221 4th Ave Sw Ste 1116, Rochester, MN 55902-3110 | 2006-09-14 |
| Find all providers with the same taxonomy | ||||
| City | MOOSE LAKE |
| Zip Code | 55767 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.