| NPI | 1750533709 |
|---|---|
| Doing Business As | COMMUNITY PHARMACY RT/DME |
| Entity Type | Organization |
| Authorized Contact | RICKY L DETWILLER Director, Outpatient Pharmacy Serv 701-530-6926 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: ND 190) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: ND 190) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2009-01-27 |