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Organization

MILLE LACS HEALTH SYSTEM

Active
Other names
MLHS Community Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM ROYCE NELSON (CEO)
(320) 532-2580
Entity
Organization

Contact information

Practice address
200 ELM ST N, ONAMIA, MN 56359-7901
(320) 532-2492
(320) 532-2499
Mailing address
200 ELM ST N, ONAMIA, MN 56359-7901
(320) 532-2492
(320) 532-2499

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
3336L0003X
Long Term Care Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
266492
MINNESOTA BOARD OF PHARMACY
MN
Enumeration date
03/09/2022
Last updated
03/13/2024
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