Organization
CASS LAKE INDIAN HOSPITAL PHARMACY
Active
Other names
CASS LAKE INDIAN HOSPITAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KAILEE FRETLAND PHARMD (PRINCIPAL PHARMACY CONSULTANT)
(240) 478-2245
Entity
Organization
Contact information
Practice address
425 7TH ST NW, CASS LAKE, MN 56633-3360
(218) 335-3313
(218) 335-3352
Mailing address
PO BOX 95421, CLEVELAND, OH 44101-0033
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
2603942
MN
333600000X
Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2046504
PK
—
05
—
966553600
—
MN
Enumeration date
02/27/2007
Last updated
10/23/2023
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