Organization
NORTH DAKOTA STATE HOSPITAL
Active
Other names
NORTH DAKOTA STATE HOSPITAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ROSALIE ETHERINGTON PHD (SUPERINTENDENT)
(701) 253-3964
Entity
Organization
Contact information
Practice address
1712 ELMWOOD PLACE, JAMESTOWN, ND 58401
(701) 269-2979
(701) 253-3035
Mailing address
1712 ELMWOOD PLACE, JAMESTOWN, ND 58401
(701) 253-3650
(701) 253-3035
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336I0012X
Institutional Pharmacy
Primary
188
ND
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2071611
PK
—
05
—
21476
—
ND
Enumeration date
05/11/2006
Last updated
02/08/2023
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