Organization
LARSEN SERVICE DRUG, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY C. LARSEN R.PH. (OWNER/PRESIDENT/PHARMACIST)
(701) 444-2410
Entity
Organization
Contact information
Practice address
334 MAIN STREET, NEW TOWN, ND 58763-0460
(701) 627-2410
(701) 627-2400
Mailing address
PO BOX 460, NEW TOWN, ND 58763-0460
(701) 627-2410
(701) 627-2400
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
390
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21402
—
ND
Enumeration date
10/31/2006
Last updated
07/12/2010
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