| NPI | 1154333730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE R WENDEL Manager 701-947-5313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: ND PHAR787) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2016-01-22 |