# NORTH DAKOTA STATE UNIVERSITY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NORTH DAKOTA STATE UNIVERSITY
- **Other names:** Family HealthCare Pharmacy, NDSU
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1194805796
- **Legal business name:** NORTH DAKOTA STATE UNIVERSITY
- **Authorized official:** JENNIFER IVERSON RPH (PHARMACIST IN CHARGE)
- **Authorized official phone:** (701) 271-6383

## Contact information

- **Practice address:** 301 NP AVENUE, FARGO, ND 58102
- **Practice address phone:** (701) 271-1489
- **Mailing address:** 301 NP AVENUE, FARGO, ND 58102
- **Mailing address phone:** (701) 271-1489
- **Mailing address fax:** (701) 271-3345

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0002X | Clinic Pharmacy | 117 | ND | Yes |

## Other

- **Enumeration date:** 10/17/2006
- **Last updated:** 08/24/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1456278 | — | ND |
| 05 | — | 707614200 | — | MN |