<Unavail>

LBN: Mesaba Drug Inc
<Unavail> is an health care organization with primary practice located at 221 Kennedy Memorial Dr , Hoyt Lakes MN 55750-1141. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Mesaba Drug Inc can be contacted via phone (218) 225-2128, or through Fossell, Mary via phone (218) 225-2128.

Contact Information

Primary practice address
221 Kennedy Memorial Dr Hoyt Lakes MN 55750-1141
Phone: (218) 225-2128
Fax: (218) 225-3455
Website:
Map and Directions
Authorized official contact:
Name: Fossell, Mary
Phone: (218) 225-2128

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 200347 Minnesota

Profile Details

NPI number 1538170048
LBN Legal business name Mesaba Drug Inc
DBA Doing business as <Unavail>
Authorized official Fossell, Mary
Entity Organization
Organization subpart 1 No
Enumeration date Aug 10th, 2006
Last updated Sep 9th, 2009 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538170048 NPPES
Other 2405531 NCPDP PROVIDER IDENTIFICATION NUMBER
MEDICAID 998058000 NCPDP PROVIDER IDENTIFICATION NUMBER

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