| NPI | 1639254113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY DOUGLAS JACOBSON President 701-234-9912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: ND 02) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2021-01-28 |