OrganizationActive
Grand Itasca Clinic and Hospital
NPI 1902379159 · Pharmacy · Grand Rapids, MN
Provider details
- NPI number
- 1902379159
- Entity type
- Organization
- Primary specialty
- PharmacySuppliers
- Parent organization
- Grand Itasca Clinic & Hospital
- Organization subpart
- Yes
- Authorized official
- Jean Macdonell, Vp, Clinic Services(218) 999-1510
Specialties & taxonomies
Suppliers
Profile Score
Established profile(67/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1601 Golf Course Rd
Grand Rapids, MN 55744-8648
Phone: (218) 999-1885
Fax: (218) 999-1887
Street-level locationGet directions
Mailing address
1601 Golf Course Rd
Grand Rapids, MN 55744-8648
Other names (DBA / former)
- Doing business as
- Grand Itasca Pharmacy
Registry dates
- Enumerated
- 2019-01-09
- Last updated
- 2019-01-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.