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Contact Information

PERHAM HOSPITAL DISTRICT
1000 CONEY ST W
PERHAM, MN56573-2102
 Phone: 218-347-1580
 Fax: 218-347-1652
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Institutional Pharmacy

3336I0012X 58 Medical Supply Company with Pharmacist
 

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for PERHAM HOSPITAL DISTRICT

NPI Number 1154467678
LBN Legal business name PERHAM HOSPITAL DISTRICT
Authorized official DUANE WALLACE - (DIRECTOR OF PHARMACY)
Entity Organization
Organization subpart 1 No
Enumeration date 01/30/2007
Last updated 06/30/2014 - About 12 years ago
Identifiers
MN License # 200303
MN Medicaid 211047400
Other 2045652 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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