Organization · Type 2 NPI

Lakewood Health System

Community/Retail Pharmacy · Staples, MN

NPI number 1508630112 Active

Practice location

49725 County 83 Ste 100
Staples, MN 56479-5280

Call (218) 894-8761 Map

Fax (218) 894-8762

Mailing address

49725 County 83
Staples, MN 56479-5280

Specialties and licenses

Taxonomy	Code	License
Community/Retail Pharmacy Primary	3336C0003X	None listed
Compounding Pharmacy	3336C0004X	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: 1508630112
Entity type: Organization (Type 2)
Issued: Nov 14, 2023
Last updated: Jun 9, 2025
Status: Active
Subpart: Yes of Lakewood Health System

Other names

<unavail>
Longbella Drug By Lakewood Health System - Staples Clinic · doing business as

Authorized official

Joseph Reycraft
CFO
(218) 894-8194

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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 1508630112

Lakewood Health System's National Provider Identifier is 1508630112, issued on Nov 14, 2023. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Staples, MN. The record was last updated on Jun 9, 2025.