Provider Demographics
NPI:1700983947
Name:DAHL PHARMACIES, INC.
Entity Type:Organization
Organization Name:DAHL PHARMACIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:D
Authorized Official - Last Name:STEFFES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-334-3159
Mailing Address - Street 1:154 COBBLESTONE LANE
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-4578
Mailing Address - Country:US
Mailing Address - Phone:612-334-3159
Mailing Address - Fax:612-334-9646
Practice Address - Street 1:154 COBBLESTONE LANE
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-4578
Practice Address - Country:US
Practice Address - Phone:612-334-3159
Practice Address - Fax:612-334-9646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1043910OtherPREFERRED ONE
MN164390OtherUCARE
MN212760100Medicaid
MN8200709OtherMEDICA
MN45729DAOtherBLUE CROSS BLUE SHIELD
MN=========OtherFEDERAL TAX ID
MN18392OtherHEALTH PARNTERS
MNA060423OtherMETROPOLITAN HEALTH PLAN
MN0232560001Medicare NSC