Organization
LBG PHARMACY INC
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN GUSTAFSON RPH (OWNER PHARMACIST)
(701) 663-1151
Entity
Organization
Contact information
Practice address
116 2ND AVE NW, MANDAN, ND 58554-3152
(701) 663-1151
(701) 663-4514
Mailing address
116 2ND AVE NW, MANDAN, ND 58554-3152
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
620
ND
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21431
—
ND
01
—
3503225
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
11/15/2006
Last updated
03/07/2023
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