Organization · Type 2 NPI

Ericksons Diversified LLC

Community/Retail Pharmacy · Northfield, MN

NPI number 1043368319 Active

Practice location

603 Division St S
Northfield, MN 55057-2426

Call (507) 645-4489 Map

Fax (507) 663-1006

Mailing address

1527 Momentum Pl
Chicago, IL 60689-5315

Specialties and licenses

Taxonomy	Code	License
Pharmacy	333600000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	None listed

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

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NPI record

NPI: 1043368319
Entity type: Organization (Type 2)
Issued: Jan 5, 2007
Last updated: Oct 29, 2025
Status: Active

Other names

<unavail>
Econofoods Pharmacy · doing business as
Econofoods Pharmacy · doing business as
Family Fare Pharmacy 3330 · doing business as

Authorized official

Amy Ellis, RPH
Director of Pharmacy
(616) 878-2848

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1043368319

Ericksons Diversified LLC's National Provider Identifier is 1043368319, issued on Jan 5, 2007. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Northfield, MN. The record was last updated on Oct 29, 2025.