Organization
NORTHERN ITASCA HOSPITAL DISTRICT
Active
Other names
Bigfork Valley Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HAROLD DANIEL ODEGAARD (CEO)
(218) 743-3177
Entity
Organization
Contact information
Practice address
258 PINE TREE DRIVE, BIGFORK, MN 56628
(218) 743-3177
(218) 743-3559
Mailing address
258 PINE TREE DRIVE, P.O. BOX 258, BIGFORK, MN 56628
(218) 743-3177
(218) 743-3559
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
261348-2
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2421840
NABP
MN
Enumeration date
06/16/2006
Last updated
08/22/2020
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