Healthcare Provider Details
I. General information
NPI: 1740116698
Provider Name (Legal Business Name): NORTH MEMORIAL HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/19/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3435 W BROADWAY AVE STE 1135
ROBBINSDALE MN
55422-2974
US
IV. Provider business mailing address
3300 OAKDALE AVE N
ROBBINSDALE MN
55422-2900
US
V. Phone/Fax
- Phone: 763-581-2815
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEPHANIE
RENEE
GALE
Title or Position: CFO
Credential:
Phone: 763-581-4635