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Organization
NORTH DAKOTA STATE HOSPITAL
Active
Organization
NORTH DAKOTA STATE HOSPITAL
Active
Other names
NORTH DAKOTA STATE HOSPITAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ROSALIE ETHERINGTON PHD (SUPERINTENDENT)
(701) 253-3964
Entity
Organization
Contact information
Practice address
1712 ELMWOOD PLACE, JAMESTOWN, ND 58401
(701) 269-2979
(701) 253-3035
Mailing address
1712 ELMWOOD PLACE, JAMESTOWN, ND 58401
(701) 253-3650
(701) 253-3035
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336I0012X
Institutional Pharmacy
Primary
188
ND
3336L0003X
Long Term Care Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2071611
PK
—
05
—
21476
—
ND
Enumeration date
05/11/2006
Last updated
02/08/2023
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