Organization
MAYO PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN F MARTIAN PHARM.D. (PHARMACIST OWNER)
(701) 223-2424
Entity
Organization
Contact information
Practice address
303 NORTH 4TH STREET, BISMARCK, ND 58501-4020
(701) 223-2424
(701) 258-2849
Mailing address
303 NORTH 4TH STREET, BISMARCK, ND 58501-4020
(701) 223-2424
(701) 258-2849
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
70
ND
3336L0003X
Long Term Care Pharmacy
PHAR70
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1454036
—
ND
01
—
3500281
NABP NCPDP
—
Enumeration date
09/26/2006
Last updated
05/20/2021
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