Organization
LAKEWOOD HEALTH SYSTEM
Active
Parent organization
LAKEWOOD HEALTH SYSTEM
Other names
Longbella Drug by Lakewood Health System - Pillager Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAKEWOOD HEALTH SYSTEM
Authorized official
JOSEPH REYCRAFT (CFO)
(218) 894-8194
Entity
Organization
Contact information
Practice address
653 PILLSBURY ST N STE 2, PILLAGER, MN 56473-2543
(218) 746-4321
(218) 746-4316
Mailing address
49725 COUNTY 83, STAPLES, MN 56479-5280
(218) 894-1515
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
266846
STATE LICENSE
MN
Enumeration date
11/14/2023
Last updated
06/09/2025
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