Organization
FAIRVIEW RANJIE REG HLTH SVS
Active
Other names
FAIRVIEW MESABA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN KRITZ (CFO)
(281) 362-6657
Entity
Organization
Contact information
Practice address
750 E 34TH ST, HIBBING, MN 55746-2341
(218) 263-4922
(218) 362-6782
Mailing address
750 E 34TH ST, HIBBING, MN 55746-2341
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
2613288
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2405466
OTHER ID NUMBER
—
05
—
411016100
—
MN
Enumeration date
09/12/2006
Last updated
04/11/2008
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