Provider Demographics
NPI:1518914720
Name:HENNEPIN COUNTY
Entity Type:Organization
Organization Name:HENNEPIN COUNTY
Other - Org Name:NORTHPOINT HEALTH CENTER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:BERGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-543-2545
Mailing Address - Street 1:2220 PLYMOUTH AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55411
Mailing Address - Country:US
Mailing Address - Phone:612-543-2533
Mailing Address - Fax:612-302-4663
Practice Address - Street 1:2220 PLYMOUTH AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55411
Practice Address - Country:US
Practice Address - Phone:612-543-2533
Practice Address - Fax:612-302-4663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X
MN2005013336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN245553601Medicaid
2044935OtherPK
MN245553601Medicaid
241801Medicare PIN