| NPI | 1508972936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODY A DOE Owner 701-764-5093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: ND 58) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2008-12-02 |