Organization
NORTHERN ITASCA HOSPITAL PHARMACY
Active
Other names
Bigfork Valley Hospital Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HAROLD DANIEL ODEGAARD (CEO)
(218) 743-4115
Entity
Organization
Contact information
Practice address
258 PINE TREE DRIVE, BIGFORK, MN 56628-0258
(218) 743-4225
(218) 743-4313
Mailing address
PO BOX 258, 258 PINE TREE DRIVE, BIGFORK, MN 56628-0258
(218) 743-4225
(218) 743-4313
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
261307
MN
3336L0003X
Long Term Care Pharmacy
261307
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2421864
NCPDP
MN
01
—
261307
LICENSE
MN
Enumeration date
12/06/2011
Last updated
03/07/2023
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