Organization
MILLE LACS HEALTH SYSTEM
Active
Other names
Mille Lacs Health System Community Pharmacy- Isle, Thompsons Lake Country Drug Inc
Organization subpart
No
Provider details
NPI number
Authorized official
TANYA PELZER (HIM SUPERVISOR, CREDENTIALING)
(320) 532-2361
Entity
Organization
Contact information
Practice address
205 MAIN ST W, ISLE, MN 56342
(320) 676-3115
(320) 676-3136
Mailing address
PO BOX 2, ISLE, MN 56342-0002
(320) 676-3115
(320) 676-3136
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
264269
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144242330
—
MN
Enumeration date
07/24/2006
Last updated
09/28/2022
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