Provider Demographics
NPI:1033341508
Name:A DOBSON INC
Entity Type:Organization
Organization Name:A DOBSON INC
Other - Org Name:MEDSAVE LONG TERM CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:DOBSON
Authorized Official - Suffix:
Authorized Official - Credentials:CPHT
Authorized Official - Phone:218-444-5228
Mailing Address - Street 1:427 MAG SEVEN CT SW STE 101
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-4453
Mailing Address - Country:US
Mailing Address - Phone:218-444-5228
Mailing Address - Fax:218-444-2451
Practice Address - Street 1:427 MAG SEVEN CT SW STE 101
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-4453
Practice Address - Country:US
Practice Address - Phone:218-444-5228
Practice Address - Fax:218-444-2451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-18
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
MN2656013336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1033341508Medicaid
MN7710980001OtherMEDICARE NSC
2121021OtherPK
MN265731OtherBOARD OF PHARMACY LICENSE
MN265731OtherBOARD OF PHARMACY LICENSE