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Organization

ELY-BLOOMENSON COMMUNITY HOSPITAL

Active
Other names
ELY COMMUNITY PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
PATRICIA BANKS (CEO)
(218) 356-8765
Entity
Organization

Contact information

Practice address
328 W CONAN ST, ELY, MN 55731-1145
(218) 365-8788
(218) 365-8789
Mailing address
328 W CONAN ST, ELY, MN 55731-1145
(218) 365-8788
(218) 365-8789

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
262191
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2048324
PK
05
218238600
MN
Enumeration date
06/24/2006
Last updated
06/18/2025
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