Organization
BETHANY PHARMACY , INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KAY M LARSON RPH (OWNER)
(701) 239-3543
Entity
Organization
Contact information
Practice address
201 UNIVERSITY DR S, FARGO, ND 58103-1775
(701) 239-3543
(701) 239-3547
Mailing address
201 UNIVERSITY DR S, FARGO, ND 58103-1775
(701) 239-3543
(701) 239-3547
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
16
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21120
—
ND
Enumeration date
01/18/2007
Last updated
08/22/2020
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