Organization
ST ALEXIUS MEDICAL CENTER
Active
Parent organization
ST ALEXIUS MEDICAL CENTER
Other names
ST. ALEXIUS COMMUNITY PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST ALEXIUS MEDICAL CENTER
Authorized official
RICK DETWILLER R.PH. (PHARMACIST)
(701) 530-6926
Entity
Organization
Contact information
Practice address
900 E BROADWAY AVENUE, BISMARCK, ND 58501
(701) 530-6906
(701) 530-8842
Mailing address
900 E BROADWAY AVENUE, BISMARCK, ND 58501
(701) 530-6906
(701) 530-8842
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
190
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
190
ND STATELICENSE
NC
Enumeration date
02/16/2007
Last updated
03/28/2012
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