MR. DALE R WHITEHEAD (NPI# 1396877221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396877221 |
| Entity Type | Individual |
| Full Name | MR. DALE R WHITEHEAD |
| Practice Address |
420 Center Ave Moorhead Drug Co Moorhead MN 56560 |
| Mailing Address |
1910 6th St S Moorhead MN 56560 |
| Practice Telephone | 2182331529 |
| Practice Fax Number | 2182338917 |
| Mailing Telephone | 2182336485 |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 3764 | ND | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | 113896 | MN | Pharmacy Service Providers |
| Street Address |
420 CENTER AVE MOORHEAD DRUG CO |
| City | MOORHEAD |
| State | MN |
| Zip Code | 56560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083608228 | Thomas N Lorentzsen | Optometrist | 420 Center Ave, Suite 41, Moorhead, MN 56560-1957 | 2005-09-02 |
| 1164794780 | Stanton L Andrist & Casey C Bartz | Optometrist | 420 Center Ave, Suite 41, Moorhead, MN 56560-1957 | 2012-01-27 |
| 1447480520 | Casey Clay Bartz | Optometrist | 420 Center Ave, Suite 41, Moorhead, MN 56560-1957 | 2009-07-22 |
| 1659506186 | Karla M Lund | Dietitian, Registered | 420 Center Ave, Moorhead, MN 56560-1957 | 2009-05-28 |
| 1962687111 | Violet M. Deilke | Durable Medical Equipment & Medical Supplies | 420 Center Ave, Suite #14, Moorhead, MN 56560-1957 | 2008-01-07 |
| 1760675755 | Seip Drug LLC | Pharmacy | 420 Center Ave, Ste 12, Moorhead, MN 56560-1957 | 2007-08-22 |
| 1376661165 | Wanda Yvonne Foley | Pharmacist | 420 Center Ave, Suite 12, Moorhead, MN 56560 | 2007-03-27 |
| 1922169168 | Dakota Clinic Ltd | Durable Medical Equipment & Medical Supplies | 420 Center Ave, Moorhead Center Mall, Moorhead, MN 56560-1957 | 2006-12-12 |
| 1841361383 | Jimpat Inc | Pharmacist | 420 Center Ave, Suite 12, Moorhead, MN 56560-1957 | 2006-11-13 |
| 1487731014 | Denise M Duke | Psychologist | 420 Center Ave, Ste 5, Moorhead, MN 56560-1962 | 2006-11-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386298859 | Anna Mckay Fox | Pharmacist | 4000 28th Avenue S, Moorhead, MN 56560 | 2019-08-01 |
| 1972019727 | Michael Wayne Hilliard | Specialist/Technologist | 649 17th St S, Moorhead, MN 56560 | 2017-12-15 |
| 1508217183 | Kristen Johnson | Nurse Practitioner | 801 Belsly Boulevard, Moorhead, MN 56560 | 2016-06-25 |
| 1861877052 | Midwest Mental Health Clinic | Nurse Practitioner | 819 30th Ave S Office 206 Suite B, Moorhead, MN 56560 | 2015-07-29 |
| 1083037709 | Drake Counseling Services, Inc. | Clinic/Center | 715 11th Street North, Suite 204, Moorhead, MN 56560 | 2014-01-31 |
| 1710310917 | Lamar Terrell Hill | Social Worker | 420 Center Ave Ste 102, Moorhead, MN 56560 | 2013-08-12 |
| 1982956140 | Lilac Homes Corporation | Assisted Living Facility | 2615 Parkview Dr, Moorhead, MN 56560 | 2012-10-11 |
| 1487918462 | Paige Joy Hanson | Massage Therapist | 805 14th St. So., Msum Wellness Center, Moorhead, MN 56560 | 2012-06-25 |
| 1972809408 | Cslm, LLC | Assisted Living Facility | 2401 South 11th Street, Moorhead, MN 56560 | 2011-02-01 |
| 1972814846 | Paul Michael Fluto | Pharmacist | 3000 Hwy 10 East, Mooehead, MN 56560 | 2010-06-25 |
| Find all providers in zip 56560 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154730893 | Erianne Siena Gibson | Pharmacist | 950 40th Ave S, Moorhead, MN 56560-6170 | 2014-08-06 |
| 1790030245 | Teresa Lutz | Pharmacist | 503 31st St N, Moorhead, MN 56560-2580 | 2012-07-20 |
| 1376808675 | Andrew William Schaaf | Pharmacist | 1610 30th Ave S, Moorhead, MN 56560-5152 | 2012-07-12 |
| 1457674376 | Scott Barglof | Pharmacist | 3000 Highway 10 E, Moorhead, MN 56560-2515 | 2010-03-05 |
| 1912140609 | Jeffrey C Braaflat | Pharmacist | 2605 8th St S, Moorhead, MN 56560-4203 | 2009-04-11 |
| 1265601322 | Larry E Nelson | Pharmacist | 1307 2nd St S Unit C, Moorhead, MN 56560-4066 | 2008-02-22 |
| 1154505345 | Corey Wayne Burnside | Pharmacist | 3300 Hwy 10 E, Cashwise Pharmacy #15, Moorhead, MN 56560-0000 | 2007-12-24 |
| 1962611632 | James Howard Bjorklund | Pharmacist | 420 Center Ave Ste 12, Moorhead Center Mall, Moorhead, MN 56560-1962 | 2007-05-21 |
| 1528679164 | Lynne Rita Anseth | Pharmacist | 700 30th Ave S, Moorhead, MN 56560-4926 | 2020-08-16 |
| 1548895733 | Kimberly Ann Bertelsen | Pharmacist | 822 30th Ave S, Moorhead, MN 56560-5006 | 2020-03-08 |
| Find all providers in MOORHEAD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.