MEDICARE: FALKS WOODLAND PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy	2612739	MN
3	3336C0003X	Community/Retail Pharmacy
4	3336C0004X	Compounding Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2421686	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1790760585
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FALKS WOODLAND PHARMACY INC

Provider Business Mailing Address
First Line	:	1 E CALVARY RD
Second Line	:
City	:	DULUTH
State	:	MN
Zip	:	55803-1514
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4507 E SUPERIOR ST
Second Line	:
City	:	DULUTH
State	:	MN
Zip	:	55804-2337
Country	:	US
Telephone Number	:	218-525-1916
Fax Number	:	218-525-3586

Authorized Official
Title or Position	:	OWNER
Name	:	STEVEN PRESTON
Credential	:	RPH
Telephone Number	:	218-525-9850

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	09/11/2025

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