PERHAM HOSPITAL DISTRICT (NPI# 1528485877) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528485877 |
| Entity Type | Organization |
| Organization Name | PERHAM HOSPITAL DISTRICT |
| Other Organization Name | PERHAM HEALTH |
| Practice Address |
1000 Coney St W Perham MN 56573-2102 |
| Mailing Address |
6501 City West Pkwy Eden Prairie MN 55344-3248 |
| Practice Telephone | 2183471571 |
| Mailing Telephone | 9526532525 |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2014-03-25 |
| Authorized Official Name | DUANE WALLACE (DIRECTOR OF PHARMACY) |
| Authorized Official Telephone | 2183471571 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | Y |
| Parent Organization Name | PERHAM HOSPITAL DISTRICT |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
| Other Name | Type Code |
|---|---|
| Perham Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558630012 | Perham Hospital District | Durable Medical Equipment & Medical Supplies | 1000 Coney Street West, Perham, MN 56573 | 2011-12-29 |
| 1710266986 | Perham Hospital District | Internal Medicine | 105 Otter Dr, Ottertail, MN 56571-7040 | 2011-08-05 |
| 1568476323 | Perham Hospital District | Skilled Nursing Facility | 735 3rd St Sw, Perham, MN 56573-1152 | 2006-07-28 |
| 1407843691 | Perham Hospital District | Home Health | 735 3rd Street Sw, Perham, MN 56573-1108 | 2005-10-03 |
| 1457631814 | Perham Hospital District | Internal Medicine | 665 3rd St Sw, Perham, MN 56573-1199 | 2011-08-17 |
| 1801176268 | Perham Hospital District | Internal Medicine | 20 W Centennial 84 Drive, New York Mills, MN 56567-0364 | 2011-08-17 |
| 1154467678 | Perham Hospital District | Pharmacy | 1000 Coney St W, Perham, MN 56573-2102 | 2007-01-30 |
| 1932113768 | Perham Hospital District | Hospitalist | 1000 Coney St W, Perham, MN 56573-2102 | 2006-07-28 |
| 1881608610 | Perham Hospital District | General Acute Care Hospital | 1000 Coney St W, Perham, MN 56573-2102 | 2006-07-28 |
| 1699789420 | Perham Hospital District | Durable Medical Equipment & Medical Supplies | 1000 Coney St W, Perham, MN 56573-2102 | 2006-07-28 |
| Street Address |
1000 CONEY ST W |
| City | PERHAM |
| State | MN |
| Zip Code | 56573-2102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982913505 | Illene T Reed | Family Medicine | 1000 Coney St W, Perham, MN 56573-2102 | 2006-05-05 |
| 1174001648 | Jodie Trites | Pharmacist | 1000 Coney St W, Perham, MN 56573-2102 | 2018-08-06 |
| 1649774670 | Colleen Ann Bauck | Registered Nurse | 1000 Coney St W, Perham, MN 56573-2102 | 2018-03-23 |
| 1770090094 | Amanda Carol Houghtaling | Nurse Practitioner | 1000 Coney St W, Perham, MN 56573-2102 | 2018-01-08 |
| 1467971572 | Rose Marie Mader | Registered Nurse | 1000 Coney St W, Perham, MN 56573-2102 | 2017-09-11 |
| 1134656994 | Matthew David Haugen | Family Medicine | 1000 Coney St W, Perham, MN 56573-2102 | 2017-05-11 |
| 1720521818 | Shannon Marie Guck | Physician Assistant | 1000 Coney St W, Perham, MN 56573-2102 | 2016-11-22 |
| 1962854646 | Rayna Bergseth | Nurse Practitioner | 1000 Coney St W, Perham, MN 56573-2102 | 2016-07-06 |
| 1821403635 | Kevin Dale Swenson | Physician Assistant | 1000 Coney St W, Perham, MN 56573-2102 | 2014-07-01 |
| 1972918472 | Melinda Kay Anderson | Nurse Practitioner | 1000 Coney St W, Perham, MN 56573-2102 | 2014-06-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558630012 | Perham Hospital District | Durable Medical Equipment & Medical Supplies | 1000 Coney Street West, Perham, MN 56573 | 2011-12-29 |
| 1730239385 | Dr. Kelvin K. Salathe, P.C. | Chiropractor | 101 West Coney St, Perham, MN 56573 | 2007-01-12 |
| 1124106299 | Langen Family Chiropractic, P.a. | Chiropractor | 108 Market Dr., Perham, MN 56573 | 2006-11-02 |
| 1285710335 | James Odin Langen | Chiropractor | 108 Market Drive, Perham, MN 56573 | 2006-10-31 |
| 1578572202 | Michael L Hamann | Dentist | 200 1st Ave S, Perham, MN 56573 | 2006-08-05 |
| 1033133517 | Timothy Charles Neitzke | Optometrist | 340 Fox St, Perham, MN 56573 | 2006-07-27 |
| 1023063757 | Shopko Stores Operating Co LLC | Pharmacy | 300 Jake St, Perham, MN 56573 | 2006-05-23 |
| 1164917233 | Katlin Larson | Behavior Technician | 735 3rd St Sw, Perham, MN 56573 | 2018-06-29 |
| 1104029347 | Tammy L Sturdevant | Dentist | 335 4th Ave, Perham, MN 56573 | 2007-06-06 |
| 1861610131 | Minnesota Eyecare Network Inc. | Eyewear Supplier (Equipment, not the service) | 340 Fox Street, Perham, MN 56573 | 2007-04-23 |
| Find all providers in zip 56573 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| 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 |
|---|---|---|---|---|
| 1518528397 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | Fairview Lakeville Clinic Mtm, 18580 Joplin Ave, Lakeville, MN 55044 | 2019-06-24 |
| 1851856504 | Tareen Dermatology, Pa | Non-Pharmacy Dispensing Site | 2945 Hazelwood St Ste 230, Maplewood, MN 55109-1241 | 2019-02-07 |
| 1417450651 | Cerner Health Connections, Inc | Non-Pharmacy Dispensing Site | 4001 Lexington Ave N Ste C2-435, Arden Hills, MN 55126-2934 | 2018-03-14 |
| 1316461593 | Fairview Pharmacy Service LLC | Non-Pharmacy Dispensing Site | 7250 France Ave S Ste 410, Edina, MN 55435-4314 | 2017-07-31 |
| 1346653052 | Advanced Spine and Pain Clinics of Mn, LLC | Non-Pharmacy Dispensing Site | 308 Brighton Ave, Suite D, Buffalo, MN 55313-2303 | 2014-06-10 |
| 1407296148 | Group Health Plan Inc | Non-Pharmacy Dispensing Site | 1833 2nd Ave, Anoka, MN 55303-2432 | 2013-06-26 |
| 1295178135 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | 6440 Nicollet Ave South, Richfield, MN 55423-1613 | 2013-04-10 |
| 1992148845 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | 2450 Riverside Ave South, Minneapolis, MN 55454-1400 | 2013-04-10 |
| 1083984876 | Mayo Clinic Health System-southeast Minnesota Region | Non-Pharmacy Dispensing Site | 32021 County 24 Boulevard, Cannon Falls, MN 55009-1824 | 2012-01-10 |
| 1255623765 | Mankato Clinic, Ltd | Non-Pharmacy Dispensing Site | 305 Main St Ne, Mapleton, MN 56065 | 2011-05-03 |
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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.