Healthcare Provider Details

I. General information

NPI: 1285557108
Provider Name (Legal Business Name): ISAIAH ALAN RATZ PHARMD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24760 HOSPITAL DRIVE
RED LAKE MN
56671-0497
US

IV. Provider business mailing address

PO BOX 497
RED LAKE MN
56671-0497
US

V. Phone/Fax

Practice location:
  • Phone: 218-679-2825
  • Fax: 218-679-0189
Mailing address:
  • Phone: 218-679-2825
  • Fax: 218-679-0189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2281520
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: