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Organization
NORTH DAKOTA STATE UNIVERSITY
Active
Organization
NORTH DAKOTA STATE UNIVERSITY
Active
Parent organization
NORTH DAKOTA STATE UNIVERSITY
Other names
Family HealthCare Pharmacy South
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTH DAKOTA STATE UNIVERSITY
Authorized official
NICOLE DANIEL RPH (PHARMACIST IN CHARGE)
(701) 551-2446
Entity
Organization
Contact information
Practice address
4025 9TH AVE S STE D, FARGO, ND 58103-2101
(701) 551-2446
(701) 364-9938
Mailing address
4025 9TH AVE S STE D, FARGO, ND 58103-2101
(701) 551-2446
(701) 364-9938
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
PHAR252
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1475078
—
ND
05
—
1972000768
—
MN
01
—
PHAR252
STATE PHARMACY LICENSE
ND
Enumeration date
04/09/2018
Last updated
02/20/2025
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