Organization
BRAINERD MEDICAL CENTER INC
Active
Parent organization
ESSENTIA HEALTH
Other names
Essentia Health Pequot Lakes Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
ESSENTIA HEALTH
Authorized official
KEVIN BOREN (VP OF FINANCE)
(218) 786-1009
Entity
Organization
Contact information
Practice address
30581 PATRIOT AVE STE A, PEQUOT LAKES, MN 56472-4112
(218) 568-5884
(218) 568-8473
Mailing address
30581 PATRIOT AVE STE A, PEQUOT LAKES, MN 56472-4112
(218) 568-5884
(218) 568-8473
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
12/17/2018
Last updated
02/26/2024
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