# MAYO PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mayo Pharmacy (LTC)
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386275121
- **Authorized official:** KEVIN F MARTIAN (OWNER)
- **Authorized official phone:** (701) 223-2424

## Contact information

- **Practice address:** 303 N 4TH ST, BISMARCK, ND 58501-4020
- **Practice address phone:** (701) 223-2424
- **Practice address fax:** (701) 258-2849
- **Mailing address:** 303 N 4TH ST, BISMARCK, ND 58501-4020
- **Mailing address phone:** (701) 223-2424
- **Mailing address fax:** (701) 258-2849

## Taxonomy

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

## Other

- **Enumeration date:** 01/30/2020
- **Last updated:** 06/18/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1454036 | — | ND |