Organization
MS4 PLLC
Active
Other names
The Medicine Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
ROSS WILHELM PHARM D (PHARMACIST/OWNER)
(701) 639-6969
Entity
Organization
Contact information
Practice address
4476 31ST AVENUE SOUTH, SUITE #105, FARGO, ND 58104
(701) 293-3060
(701) 293-3061
Mailing address
4476 31ST AVE S STE 105, FARGO, ND 58104-4532
(701) 639-6969
(701) 639-6987
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHAR447
ND
3336C0003X
Community/Retail Pharmacy
Primary
PHAR447
ND
Other
Enumeration date
07/31/2018
Last updated
12/09/2021
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