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General NPI Number Information
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NPI Number | 1053694885
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Entity Type | Organization
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Legal Business Name | NORTHERN PINES MEDICAL CENTER
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Dates
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Enumeration Date | 09/28/2011
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Last Update Date | 04/26/2016
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Provider Practice Location Address
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Address Line | 5211 HIGHWAY 110
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City | AURORA
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State | MN
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Zip | 55705-1522
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Country | US
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Telephone | 218-229-4210
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Fax | 218-229-4261
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Provider Business Mailing Address
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Address Line | 5211 HIGHWAY 110
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City | AURORA
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State | MN
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Zip | 55705-1522
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Country | US
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Telephone | 218-229-4210
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Fax | 218-229-4261
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Authorized Official
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Title or Position | DIRECTOR OF ACUTE CARE PHARMAC
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Name | JAMES TOMSCHE
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Credential | RPH
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Telephone | 218-786-4346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | 200749
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License Number State | MN
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