Organization
CHASE DRUG STORE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE CHASE (OWNER/MANAGER)
(701) 462-8174
Entity
Organization
Contact information
Practice address
703 MAIN AVENUE, WASHBURN, ND 58577-0400
(701) 462-8174
(701) 462-3597
Mailing address
703 MAIN AVE, PO BOX 400, WASHBURN, ND 58577
(701) 462-8174
(701) 462-3597
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
160
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20164
—
ND
01
—
70482
BCBS OF ND
—
Enumeration date
08/22/2006
Last updated
05/15/2008
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