| NPI | 1881310282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WYATT ELDON MARTENSON Owner/President 701-873-5215 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2022-10-18 |