Organization
BEULAH DRUG COMPANY
Active
Other names
BEULAH DRUG COMPANY
Organization subpart
No
Provider details
NPI number
Authorized official
WYATT ELDON MARTENSON PHARMD (OWNER/PIC)
(701) 873-5215
Entity
Organization
Contact information
Practice address
147 W MAIN ST, BEULAH, ND 58523-6969
(701) 873-5215
(701) 873-4908
Mailing address
PO BOX 99, BEULAH, ND 58523-0099
(701) 873-5215
(701) 873-4908
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHAR145
ND
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1451296
—
ND
01
—
2070746
PK
—
Enumeration date
06/13/2006
Last updated
09/14/2021
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