Organization
GRAND ITASCA CLINIC AND HOSPITAL
Active
Parent organization
GRAND ITASCA CLINIC AND HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRAND ITASCA CLINIC AND HOSPITAL
Authorized official
MELISSA WALTERS (DIRECTOR OF PHARMACY)
(952) 653-2565
Entity
Organization
Contact information
Practice address
1601 GOLF COURSE RD, GRAND RAPIDS, MN 55744-8648
(218) 326-7503
Mailing address
6501 CITY WEST PKWY, EDEN PRAIRIE, MN 55344-3248
(952) 653-2565
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
09/14/2010
Last updated
09/14/2010
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