Provider Demographics
NPI:1114157310
Name:AITKIN COMMUNITY HOSPITAL INC.,
Entity Type:Organization
Organization Name:AITKIN COMMUNITY HOSPITAL INC.,
Other - Org Name:GARRISON CLINIC PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:ALTON
Authorized Official - Last Name:WESTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-927-5501
Mailing Address - Street 1:200 BUNKER HILL DR
Mailing Address - Street 2:
Mailing Address - City:AITKIN
Mailing Address - State:MN
Mailing Address - Zip Code:56431
Mailing Address - Country:US
Mailing Address - Phone:218-927-2121
Mailing Address - Fax:218-927-5319
Practice Address - Street 1:27278 STATE HIGHWAY 18
Practice Address - Street 2:
Practice Address - City:GARRISON
Practice Address - State:MN
Practice Address - Zip Code:56450
Practice Address - Country:US
Practice Address - Phone:320-525-3401
Practice Address - Fax:320-525-3439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-22
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN263024332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN812137000Medicaid
MN812137000Medicaid