# MS4 PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Medicine Shoppe Long Term Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063140010
- **Authorized official:** LANELL HAGEN (PHARMACIST/OWNER)
- **Authorized official phone:** (701) 293-0221

## Contact information

- **Practice address:** 4476 31ST AVE S STE 105, FARGO, ND 58104-4532
- **Practice address phone:** (701) 639-6969
- **Mailing address:** 4476 31ST AVE S STE 105, FARGO, ND 58104-4532
- **Mailing address phone:** (701) 639-6969

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 08/09/2022
- **Last updated:** 08/09/2022