| NPI | 1720527120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY KRUEGER Owner 701-720-6187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: ND PHAR565) |
| Enumeration Date | 2017-02-17 |
| Last Update Date | 2023-06-26 |