| NPI | 1265548101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE CHASE Owner/Manager 701-462-8174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: ND 160) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2008-05-15 |