Organization
MEDICAL PHARMACY MOORHEAD INC
Active
Other names
MEDICAL PHARMACY MOORHEAD
Organization subpart
No
Provider details
NPI number
Authorized official
SHEILA NUDELL RPH (PRESIDENT AND MANAGER)
(218) 233-7365
Entity
Organization
Contact information
Practice address
101 11TH ST S, MOORHEAD, MN 56560-2899
(218) 233-7365
(218) 233-5702
Mailing address
101 11TH ST S, MOORHEAD, MN 56560-2899
(218) 233-7365
(218) 233-5702
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
260722
MN
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021062
—
ND
05
—
066360300
—
MN
01
—
2046710
PK
—
Enumeration date
02/24/2007
Last updated
02/20/2017
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